Korean J Ophthalmol.  2013 Apr;27(2):137-140. 10.3341/kjo.2013.27.2.137.

Kimura Disease Involving a Caruncle

• Kim WJ
• Chung MJ
• You IC

• KMID: 1503808
• DOI: http://doi.org/10.3341/kjo.2013.27.2.137

Abstract

A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 x 0.5 x 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.

Keyword

Angiolymphoid hyperplasia with eosinophilia; Asian continental ancestry group; Caruncle; Women

MeSH Terms

Adult
Angiolymphoid Hyperplasia with Eosinophilia/*diagnosis
Asian Continental Ancestry Group
Conjunctiva/*pathology
Conjunctival Diseases/*diagnosis
Diagnosis, Differential
Female
Humans

Figure

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  Fig. 1 A slit lamp biomicroscopic finding on the patient's initial visit revealed a conjunctival nodule in the left medial canthal area.

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  Fig. 2 Histological findings of mass lesion (hematoxylin-eosin stain, ×100). Chronic inflammation with multiple follicular lymphoid hyperplasia with nodal germinal center.

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  Fig. 3 Numerous infiltrated eosinophils with fibrous septa (hematoxylin-eosin stain, ×400).

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  Fig. 4 Multiple capillary proliferation with normal flat, spindle-shaped vascular endothelium (hematoxylin-eosin stain, ×400).

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  Fig. 5 Immunohistochemical staining for CD20 and CD3 in Kimura disease (×200). The germinal center B-lymphocytes of follicles is positive for CD20 (A) and CD3 stained in the surrounding mantle zone of T-lymphocytes (B).

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