[Soft tissue eosinophilic granuloma or Kimura's disease: a case report]

Soft tissue eosinophilic granuloma or Kimura's disease is a chronic inflammatory disorder of unknown etiology. It is endemic in the Far East but can occur sporadically in other populations especially Middle Eastern peoples as illustrated by the present case involving a 55-year-old man. Examination 8 years after an initial episode revealed masses in the cheek and submaxillary regions with hypereosinophilia and characteristic histological findings. The usual clinical presentation of Kimura's disease includes subcutaneous nodules with lymph node involvement or presence of tumor in the salivary glands. These clinicopathological findings require differential diagnosis with Hodgkin's lymphoma, dermopathic lymphoma, or Castelman's disease. However, the most difficult distinction involves angiolymphoid hyperplasia with eosinophilia. Final diagnosis requires anatomopathological study. The most frequently encountered histological criteria are preservation of node structure, highly developed germinal centers, eosinophilic infiltration, and presence of numerous postcapillary veinlets. Prognosis is favorable but multiple relapses are possible. Corticosteroid therapy is usually effective but radiation treatment may be necessary in patients with recurrent disease.