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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 92-93

Kimura's disease: A diagnostic dilemma


Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi 110 029, India

Date of Submission19-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Navin Kumar
Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2154_19

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How to cite this article:
Kumar N, Bhoriwal S. Kimura's disease: A diagnostic dilemma. Indian J Med Res 2020;152, Suppl S1:92-3

How to cite this URL:
Kumar N, Bhoriwal S. Kimura's disease: A diagnostic dilemma. Indian J Med Res [serial online] 2020 [cited 2021 Jul 29];152, Suppl S1:92-3. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/92/316751

Patient's consent obtained to publish clinical information and images.


A 19 yr old male patient presented to the Surgical Oncology outpatient department, All India Institute of Medical Sciences (AIIMS), New Delhi, India, in December 2018, with the chief complaints of painless progressive swelling of right-sided face for seven years. On clinical examination [Figure 1], there was a solitary large soft cystic swelling measuring 16 ×16 cm in the right parotid region. Computed tomographic scan revealed subcutaneous oedema and fat reticulations in the right parotid region [Figure 2]. Core biopsy histopathology was suggestive of Kimura's disease (KD)/angiolymphoid hyperplasia [Figure 3]. The patient was treated with neoadjuvant radiotherapy (50.4 Gy, 28 fractions, six weeks) followed by surgical excision of the mass lesion and superficial parotidectomy with pectoralis major myocutaneous flap reconstruction. Final specimen histopathology rendered lymphoid hyperplasia. After nine months of follow up, the patient was disease-free.
Figure 1: Pre-treatment image showing right-sided face and parotid region painless and progressively increasing swelling (arrow).

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Figure 2: Axial (A) and coronal (B) contrast-enhanced computed tomographic scan images showing subcutaneous oedema and fat reticulations (white arrows) in the right parotid region with an irregular outline of the right parotid gland.

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Figure 3: Core biopsy showing fibroadipose tissue with lobules of inflammatory cells, i.e. lymphocytes, eosinophils and interspersed small vascular channels lined by plump endothelial cells, suggestive of angiolymphoid hyperplasia with eosinophilia (H and E, ×40).

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Acknowledgment: Authors thank Dr Aanchal Kakkar, department of Pathology, AIIMS, New Delhi, for providing pathological microphotograph and its details, Dr Ritesh Kumar, department of Radiotherapy, AIIMS, New Delhi, for providing radiation services to the patient and referral of the patient to surgical oncology services.

Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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