Kimura Disease

Kimura disease is a rare, benign, chronic inflammatory condition of unknown etiology. Histopathologically, it is manifested by an abnormal proliferation of lymphoid follicles and vascular endothelium, and clinically the disorder involves the skin, lymph nodes, and salivary glands. Kimura disease is usually seen in young adults during the third decade of life. Patients typically present with a solitary enlarged lymph node or generalized lymphadenopathy. We report a case of a 60-year-old nondiabetic, normotensive man who presented with complaints of low-grade fever and dry cough of 6 months duration. He had multiple firm, discrete, painless, enlarged cervical lymph nodes. Chest radiography revealed a right pleural effusion. A complete blood count showed an increased absolute eosinophil count. Pleural fluid examination revealed an eosinophillic exudate. Pleural biopsy was negative for granulomatous inflammation or malignant disease. Lymph node biopsy showed congested blood vessels with moderate eosinophilic infiltration of the cortex of the lymph node consistent with Kimura disease. No follicular hyperplasia or granulomas were seen. Oral prednisolone therapy was initiated and the patient showed gradual improvement in symptoms and complete resolution of pleural effusion.