Imaging and pathologic features of eosinophilic hyperplastic lymphogranuloma in head and neck region

Objective: To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods: The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results: In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: (1) Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T1-weighted sequence and iso- or hypo-intensity in T2-weighted sequence mostly, with different enhancement after administration of contrast medium. (2) The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. (3) All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion: The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased. (authors)