木村病1例

A Case of Kimura Disease

患者女,31岁。10年前发现双侧耳后、上颈部和上臂皮下肿块,无瘙痒和疼痛,逐渐蔓延至腹股沟、腋下、耳前、上眼睑和嘴角下侧等部位。5年前躯干、四肢出现红斑、丘疹、丘疱疹,伴剧烈瘙痒,无发热、咳嗽等全身不适症状。实验室检查:中性粒细胞、嗜酸性粒细胞、单核细胞计数及百分比增高。皮损组织病理示:真皮内大量淋巴细胞增生并形成淋巴滤泡,可见淋巴细胞周围胶原硬化,淋巴滤泡周围见大量嗜酸性粒细胞和淋巴细胞浸润,未见明显增生的血管。予氨苯砜、抗组胺药等治疗后病情较前改善。

A 31-year-old woman presented with l0 years history of subcutaneous tumors on the post aurem, neck and upper ann, no itch and pain was found of the lesions. The lesions spread to the inguina, axil, preauricula, upper eyelid and angulus oris. Five years ago there were erythema plaques, papules, papulovesicles with extreme itch on the trunk and extremities. No fever, cough and other symptoms were found. Laboratory examination showed abnormal high lever of neutrophils, eosinophoils and monocytes. Histopathological examination showed dense lymphocytes infiltration in the dermis with well formed follicle. There were sclerosis of collagen around the lymphocytes and lots of eosinophils and lymphocytes infiltrated around the follicle. No prominent vascular proliferation was found. The lesions showed improvement after treatment with DDS and antihistamine drugs.