Kimura's disease

An Asian man aged 42 had a pre-auricular swelling on the left with local skin itching. Owing to the highly probably benign nature at examination, surgical treatment was refrained from. One year later, the swelling had increased while the itching was unchanged, so that surgical excision was performed. Morbid-anatomical examination revealed angiolymphoid hyperplasia with eosinophilia, compatible with Kimura's disease. Kimura's disease is a chronic inflammatory disorder which is very rare in Europe, but which is frequently diagnosed in Asian countries and in immigrants from these countries. Tumours in the head and neck region, enlarged lymph nodes and increased eosinophil counts are typical signs. The IgE level is increased. The cause of this disease is so far not clear, although there are indications that an inflammatory reaction to an unknown allergen plays a part. It is essential that this disease should be distinguished in the diagnostic work-up from presence of a malignancy. Fine-needle aspiration cytology is often inconclusive; as a rule the diagnosis can only be made after surgical excision of the tumour. There is no consensus on the treatment of this disease, but symptomatic therapy usually suffices.