A Case of Kimura's Disease Arising from Epiglottis

Kim, Eun Seo; Han, Jae Wook; Lee, Ek Ho; Yang, Woo Ick

Abstract

Kimura's disease is a chronic inflammatory disease which commonly affects the head and neck regions in young oriental men. It is a rare disease and is found as tumor-like painless swelling with or without lymphadenopathy. However, it's treatment method is not clearly defined. The purpose of this article is to report a very unusual case which is often mistaken for a malignant tumor. A 15-year old male was seen with diffuse epiglottic swelling and cervical lymphadenopathy. CT and MRI showed diffusely enlarged epiglottis with homogenous ensity and bilateral multiple lymphadenopathy in internal jugular and spinal accessory chains. Biopsy of epiglottic mass was performed under the impression of malignant lymphoma. The histology revealed marked lymphoid follicular hyperplasia and massive interfollicular eosinophilic cell infiltration, which was compatible with Kimura's disease. The mass was partially excised especially in laryngeal surface area because the mass was not separated from epiglottis itself. After surgical removal, oral prednisolone was taken. The epiglottis was nearly returned to its normal figure after subsequent excision and vaporization with CO2 laser and neck nodes enlargements were spontaneously resolved. The etiology of this disease is still unknown. It is essential to differentiate it with malignant tumor through biopsy. When Kimura's disease is confirmed, combination of surgical excision and oral steroid appear to be effective therapeutic modality.