被误诊为淋巴瘤的木村病1例及文献复习

Kimura's disease misdiagnosed as lymphoma:a case report and literature review

目的探讨木村病的临床特征,以提高临床医师对该病的认识。方法报道1例最初被误诊为淋巴瘤,后病理活检证实为木村病的患者的临床资料,并结合国内外文献进行复习分析。结果本例患者男性,74岁,临床表现为单纯无痛性左侧面颊部皮下肿块,嗜酸性粒细胞计数轻度增高,激素治疗后缩小。面部MRI平扫示:左侧腮腺区混合信号影,考虑占位性病变。初步考虑为淋巴瘤,后经术后病理诊断为木村病。结论当患者出现无痛性头颈部皮下肿块、嗜酸性粒细胞及血清IgE升高三联征时需考虑木村病的可能,需进一步完善肿块CT、MRI检查,必要时活检予以明确诊断。

Objective To investigate the clinical characteristics of Kimura's disease,in order to improve clinicians'understanding of the disease.Methods This paper reported the clinical data of a patient who was misdiagnosed as lymphoma at first and later confirmed as Kimura's disease by pathological biopsy,and the literature at home and abroad was reviewed.Results In this case,a 74 year old male presented with a simple painless subcutaneous mass on the left cheek.The eosinophil count slightly increased and shrank after hormone therapy.Plain MRI of the face showed mixed signal shadow in the left parotid gland area,considering space-occupying lesions.The primary consideration was lymphoma,and the postoperative pathological diagnosis was Kimura's disease.Conclusions The possibility of Kimura's disease should be considered when the patient has a painless head and neck subcutaneous mass,coupled with increased eosinophil count and elevated serum IgE.The CT and MRI examination of the mass is needed for clarification.If necessary,biopsy of mass should be performed to confirm the diagnosis.