颌面部木村病超声特征、临床特点分析并文献复习

Ultrasonic characteristics,clinical characteristics and literature review of Kimura disease in the maxillofacial region

目的:探讨颌面部木村病(Kimura disease,KD)的超声特征及临床特点,总结诊断经验。方法:对2010年1月—2022年6月山西省肿瘤医院收治的26例KD患者的临床资料及超声图像进行回顾性分析。分析其超声特征及临床特点,并总结诊断经验。结果:本研究共入组KD患者26例,男20例,女6例(性别比3.3∶1)。患者年龄中位数为45岁6月。血常规显示所有患者血清嗜酸性粒细胞的百分比值均增加。超声声像图结果显示26例患者均检出病灶,淋巴瘤可能5例(19.23%),恶性病灶6例(23.08%),多形性腺瘤4例(15.38%),性质待诊建议穿刺活检11例(42.31%)。单纯淋巴结型8例(30.77%),单纯累及腮腺+周围软组织型11例(42.31%),同时累及腮腺+周围软组织+淋巴结型7例(26.92%)。对不同类型KD患者病灶的超声特征进行比较,其在边界、形态、混合回声上的差异具有统计学意义(P<0.05)。组织病理学可见淋巴滤泡增生,嗜酸性粒细胞发生浸润,部分生发中心坏死或者形成嗜酸性微脓肿。结论:KD以中青年男性居多,病变多累及头颈部,KD的超声及临床表现容易误诊,应结合组织病理学检查,以提高诊断准确性。

Objective:To explore the ultrasonic features and clinical features of Kimura disease(KD)in the maxillofacial region and summarize the diagnostic experience.Methods:A retrospective analysis was conducted on the clinical data and ultrasound images of 26 patients with KD admitted to Shanxi Cancer Hospital from January 2010 to June 2022.The ultrasound and clinical features were analyzed and the diagnostic experience was summarized.Results:A total of 26 patients with KD were enrolled in this study,including 20 males and 6 females(Sex ratio 3.3∶1).The median age of the patients was 45 years and 6 months.Blood routine examination showed that the percentage of serum eosinophil increased in all patients.The ultrasound results showed that lesions were detected in all 26 patients,with 5 cases of lymphoma(19.23%),6 cases of malignant lesions(23.08%),4 cases of pleomorphic adenomas(15.38%)and 11 cases(42.31%)of undetectable nature suggested puncture biopsy.In this group,there were 8 cases(30.77%)with simple lymph node type,11 cases(42.31%)with simple parotid gland+surrounding soft tissue type,and 7 cases(26.92%)with parotid gland+surrounding soft tissue+lymph node type.Comparison of ultrasonic features of different types of lesions in KD showed statistically significant differences in boundary,morphology and mixed echo(P<0.05).Histopathology showed lymphoid follicular hyperplasia,infiltration of eosinophils,necrosis of some germinal centers or formation of eosinophilic micro abscesses.Conclusion:KD mainly occurs in young and middle-aged men and most of the lesions involve the head and neck.Ultrasonic and clinical manifestations of KD are easy to be misdiagnosed.It should be diagnosed in combination with histopathological examination to improve the diagnostic accuracy.