Kimura disease: diagnostic challenges and clinical management.

Area of Science:

• Head and Neck Surgery
• Immunopathology
• Oncology

Background:

• Kimura disease is a rare, benign inflammatory condition affecting the head and neck, typically in young Asian males.
• It often presents as a painless mass in a major salivary gland accompanied by lymphadenopathy.
• The pathogenesis is thought to involve an immunologic mechanism.

Observation:

• Histopathology reveals vascular proliferation and eosinophil-rich lymphoid infiltrate.
• Immunohistochemistry is generally nonspecific but aids in excluding malignancy.
• Fine needle aspiration (FNA) and biopsy have limited diagnostic utility for Kimura disease.

Findings:

• The disease course is generally indolent with no reported malignant transformation.
• Recurrence, however, is a common clinical feature.
• Two cases with varied presentations and diagnostic hurdles are detailed.

Implications:

• Accurate preoperative diagnosis of Kimura disease is challenging.
• Surgical management requires careful consideration to reduce morbidity and recurrence rates.
• A high index of suspicion is vital for effective clinical management.