A case of Kimura's disease: Approach by immunohistochemical study and analysis of clonality

Kimura's disease is a chronic, inflammatory disorder of unknown origin. It is characterized by clinically recurrent painless swelling on head and neck region, histopathologically multiple lymphoid follicles, increased serum IgE levels, and eosinophilia of tissue and peripheral blood. It has been known that Kimura's disease is the reactive immunological disease. Recently, however, it was suggested the clonal T cell proliferation might contribute to the pathogenesis in the Kimura's disease. But, it is still uncertain that Kimura's disease is of reactive nature or neoplastic origin. A 71-year-old woman visited our clinic with painless violaceous swelling on her right cheek. Skin biopsy was performed and, taken together, Kimura's disease was diagnosed. Tissue section was examined with immunohistochemical stains with markers of lymphocytes, plasma cell, and periendothelial cell, and polymerase chain reaction for the TCR gene rearrangement was performed. We present a case of Kimura's disease investigated by the immunohistochemical study and TCR gene rearrangement test and suggest this case is in the limited favor of the reactive nature of Kimura's disease.