Kimura病33例临床分析

A clinical analysis of 33 cases of Kimura′s disease

目的:探讨Kimura病(KD)的临床特征、病理学表现和并发症等,提高对该病的认识及诊疗水平。方法:回顾性分析33例确诊为KD患者的临床资料。结果:22例表现为头颈部肿块,11例表现为身体其他部位肿块,如腹股沟、腋窝、肺门及肠系膜根部等;21例累及淋巴结,8例发生于大唾液腺;23例外周血嗜酸性细胞升高,2例行血清总IgE检测,均明显升高;7例尿常规异常,其中3例为大量蛋白尿(+++),2例为血尿(+);6例行骨髓细胞学检查,其中2例嗜酸性细胞升高;2例并发肾病综合征;6例并发头颈部局限性炎性疾病,2例并发恶性肿瘤。结论:KD常表现为头颈部肿块,多累及淋巴结和大唾液腺。不明原因外周血嗜酸性细胞升高的患者应考虑到KD的可能,血清总IgE和肿块病理检查有助于KD的早期诊断。

Objective：To improve the diagnosis and treatment of Kimura′s disease（KD） by investigating its clinical characteristics,pathological features and complications.Method：The clinical data of 33 cases of KD were analyzed retrospectively.Result：Of 33 cases,22 showed the mass on head and neck,while in the other cases,the mass distributed in the region of groin,axillary fossa,hilum of lung and mesentery.Regional lymph nodes were involved in 21 cases and major salivary glands were invaded in 8 cases.Twenty-three cases had typical peripheral eosinophilia,although only in 2 patients the quantity of serum total IgE increased markedly.Urine abnormalities happened to 7 cases,such as massive proteinuria（3 cases） and hematuria（2 cases）.Among 6 cases which underwent bone marrow aspiration,2 showed eosinophilia.Two cases were complicated with nephritic syndrome.Six cases were combined with local inflammation on head and neck and 2 cases were combined with malignant tumor.Conclusion：Mass on the head and neck is the typical clinical manifestation in KD,with regional lymph nodes and major salivary glands involved most.Serum total IgE and histopathologic examination should always be done to confirm KD,especially in the cases with unknown eosinophilia increasing.