4/28/2015

KimuraDiseaseWorkup

KimuraDiseaseWorkup
Author:EvanWPiette,MDChiefEditor:WilliamDJames,MDmore...
Updated:Mar20,2014

LaboratoryStudies
NearlyallpatientswithKimuradiseasedemonstrateperipheraleosinophiliaandelevatedlevelsofserumIgE.In
oneseries,thenumberofeosinophilswascloselycorrelatedtothesizesoftheneckmasses. [19]
Bloodureanitrogen,creatinine,andurinaryproteinlevelsshouldbeobtainedtoexcludeconcomitantrenal
dysfunction(especiallynephroticsyndrome).
Serumeosinophilcationicproteinlevelsparallelthecourseofthedisease. [20]

ImagingStudies
TheappearanceofKimuradiseaseonimagingmodalities,includingCTscanningandMRI,isvariableandis
thoughttobedue,atleastinpart,tothevariabledegreesofvascularproliferationandfibrosiswithinindividual
lesions.Oneofthelargestcaseseriestodatenotesthecharacteristicfindingstobemultipleilldefined,enhancing
lesionsaroundtheparotidgland,withassociatedlymphadenopathy. [15]

Procedures
IncisionalbiopsyisrecommendedtoobtainthediagnosisofKimuradisease.

HistologicFindings
Lymphoidnoduleswithdiscretegerminalcenterscanoccupyanareaextendingfromthereticulardermistothe
fasciaandmuscle.Amarkedeosinophilicinfiltrateandeosinophilicabscessesarepresent.Centrally,thickwalled
vesselsarepresentwithhobnailendothelialcells.Immunohistochemicalevaluationofthelymphoidnodules
demonstratesapolymorphousinfiltratewithoutclonality. [7,15]Reportshavealsodemonstratedthepresenceof
plasmacytoiddendriticcellsinalesionofKimuradisease. [21]

ContributorInformationandDisclosures
Author
EvanWPiette,MDResidentPhysician,DepartmentofDermatology,HospitaloftheUniversityofPennsylvania
EvanWPiette,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofDermatology
Disclosure:Nothingtodisclose.
Coauthor(s)
AlainaJJames,MD,PhDAssistantProfessor,DepartmentofDermatology,TheHospitaloftheUniversityof
Pennsylvania
AlainaJJames,MD,PhDisamemberofthefollowingmedicalsocieties:AmericanAcademyofDermatology,
NationalMedicalAssociation,andWomen'sDermatologicSociety
Disclosure:Nothingtodisclose.
SpecialtyEditorBoard
TakejiNishikawa,MDEmeritusProfessor,DepartmentofDermatology,KeioUniversitySchoolofMedicine
Director,SamonchoDermatologyClinicManagingDirector,TheWaksmanFoundationofJapanInc
Disclosure:Nothingtodisclose.
MichaelJWells,MDAssociateProfessor,DepartmentofDermatology,TexasTechUniversityHealthSciences
Center,PaulLFosterSchoolofMedicine
MichaelJWells,MDisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,AmericanAcademyof
Dermatology,AmericanMedicalAssociation,andTexasMedicalAssociation
Disclosure:Nothingtodisclose.
DanielSLoo,MDAssociateProfessorofDermatology,ResidencyProgramDirector,Departmentof
Dermatology,TuftsMedicalCenter
DanielSLoo,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofDermatologyand
AssociationofProfessorsofDermatology
Disclosure:Nothingtodisclose.
JoelMGelfand,MD,MSCEMedicalDirector,ClinicalStudiesUnit,AssistantProfessor,Departmentof
Dermatology,AssociateScholar,CenterforClinicalEpidemiologyandBiostatistics,UniversityofPennsylvania

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KimuraDiseaseWorkup

JoelMGelfand,MD,MSCEisamemberofthefollowingmedicalsocieties:SocietyforInvestigative
Dermatology
Disclosure:AMGENConsultingfeeConsultingAMGENGrant/researchfundsInvestigatorGenentech
Grant/researchfundsinvestigatorCentocorConsultingfeeConsultingAbbottGrant/researchfundsinvestigator
AbbottConsultingfeeConsultingNovartisinvestigatorPfizerGrant/researchfundsinvestigatorCelgene
ConsultingfeeDMCChairNIAMSandNHLBIGrant/researchfundsinvestigator
ChiefEditor
WilliamDJames,MDPaulRGrossProfessorofDermatology,ViceChairman,ResidencyProgramDirector,
DepartmentofDermatology,UniversityofPennsylvaniaSchoolofMedicine
WilliamDJames,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofDermatologyand
SocietyforInvestigativeDermatology
Disclosure:Nothingtodisclose.
AdditionalContributors
SenaJLee,MD,PhDResidentPhysician,DepartmentofDermatology,HospitalofUniversityofPennsylvania
Disclosure:Nothingtodisclose.
PatriciaMercado,MDAssociateProfessorofDermatology,UniversityofAlabamaatBirminghamSchoolof
Medicine
Disclosure:Nothingtodisclose.
LauraMTamburin,MDAffiliatedDermatology,PC
Disclosure:Nothingtodisclose.
KarolynAWanat,MDResidentPhysician,DepartmentofDermatology,UniversityofPennsylvaniaSchoolof
Medicine
KarolynAWanat,MDisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,AmericanAcademy
ofDermatology,AmericanMedicalAssociation,andAmericanMedicalWomen'sAssociation
Disclosure:Nothingtodisclose.

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