Kimura病的病理学分析

目的:探讨Kimura病(Kimura’s disease,KD)的临床病理学特点,提高对该病的认识及诊断。方法:分析和观察7例KD的临床资料、病理组织学表现及免疫组织化学特征。结果:7例KD患者均为男性,发病年龄21～73岁,主要表现为头颈部皮下或大唾液腺的无痛性肿块,组织学上以淋巴组织增生为主,可见淋巴滤泡形成,生发中心扩大,滤泡间见血管增生,大量嗜酸性粒细胞浸润。免疫组织化学显示KD中的淋巴滤泡表达B细胞抗原,滤泡间的淋巴细胞多表达T细胞标记。结论:KD是一种少见的淋巴组织增生性疾病,需与部分富含淋巴组织的肿瘤鉴别,组织病理学及免疫组化对其诊断具有重要意义。     

颜面部多发性复发性嗜酸性粒细胞增生性淋巴肉芽肿1例及文献复习

嗜酸性粒细胞增生性淋巴肉芽肿又称木村病（Kimura disease,KD）,发病率低,病因不明,其确诊依靠组织病理学检查,镜下有显著生发中心的淋巴组织增生及淋巴滤泡形成,嗜酸性粒细胞在淋巴结内灶性聚集,形成嗜酸性微脓肿。临床上对于头颈部无痛性皮下肿物及局部淋巴结肿大的患者,尤其是伴外周血嗜酸性粒细胞及血清IgE增高者,应考虑KD可能,手术和放疗可取得一定疗效,但复发率较高。笔者报道颜面部多发性复发性KD1例。     

鼻背区嗜酸性粒细胞增生性淋巴肉芽肿1例报告

正嗜酸性粒细胞增生性淋巴肉芽肿于1937年由金显宅首先报道。1948年日本学者Kimura(木村)作较详细的描述,故此病又称木村病(Kimura Disease,KD)。很少发生于鼻部。本文报道1例鼻背部嗜酸性粒细胞增生性淋巴肉芽肿患者。     

木村病临床研究进展

木村病（Kimura disease,KD）,又称“嗜酸性粒细胞增生性淋巴肉芽肿”,首先由中国金显宅等于1937年以“嗜伊红球增多性淋巴母细胞瘤”之名报道7例,当时认为是一种肿瘤。1948年经日本学者Kimura（木村）等人首先做出“不寻常性淋巴组织增生性肉芽肿”的描述,并由此命名。该病是一种慢性进行性软组织肉芽肿病变,     

口腔颌面部嗜酸性淋巴肉芽肿的临床病理研究

目的：探讨口腔颌面部嗜酸性淋巴肉芽肿（Kimura病）的临床病理学特征。方法：对武汉大学口腔医院诊治的28例口腔颌面部嗜酸性淋巴肉芽肿病例资料。分别从患者性别、发病年龄、临床表现、发病部位、实验室检查及组织病理学等方面进行回顾性分析。应用免疫组织化学方法行同种异体移植炎症因子（allografl inflammatory factor-1，AIF-1）染色。28例患者中，男性19例，女性9例，中位年龄40岁。结果：此28例嗜酸性淋巴肉芽肿患者以腮腺区为多发部位。主要临床表现为皮下单发或多发性结节样肿块。外周血嗜酸性粒细胞计数平均为9％。组织病理学表现为淋巴组织增生并形成淋巴滤泡。内含活跃的生发中心，滤泡间可见大量增生的毛细血管后微静脉型血管；血管周围及滤泡间大量的嗜酸性粒细胞浸润并形成散在的嗜酸性微脓疡。免疫组织化学检测28例标本淋巴滤泡的生发中心AIF-1染色阳性。结论：嗜酸性淋巴肉芽肿是一种具有较明显临床及病理学特征的慢性炎症性疾病，免疫调节异常是其可能发病机制。     

多发性嗜酸性淋巴肉芽肿1例及文献回顾

报道1例多发性嗜酸性淋巴肉芽肿病例,并复习该病的相关国内外文献。多发性嗜酸性淋巴肉芽肿发病率低,且病因至今未明。临床上常表现为头颈部淋巴结肿大、嗜酸性粒细胞及Ig E增高。病理学上表现为淋巴组织增生并形成淋巴滤泡,生发中心极性存在,血管周围及滤泡间大量的嗜酸性粒细胞浸润。放疗、药物治疗及手术切除均可达良好疗效,但易复发。     

Kimura病

Kimura病又称为嗜酸性粒细胞增生性淋巴肉芽肿(eosinophilichyperplasticlymphogranuloma),临床上比较少见。1937年,Kimm和Szeto在中华医学会年会上报道7例嗜酸性粒细胞增生性肉芽肿病例;其后,1948年,Kimura等发表了题为“论合并淋巴组织增生改变的不寻常肉芽肿”一文,以致后来文献上多将此种病理状态称为Kimura病。临床上表现为慢性炎症性改变,可见(及)皮下肿瘤样结节。多见于东方人,好发于头颈部,常伴大唾液腺、泪腺肿大和区域淋巴结病变。组织病理学特征为皮下组织内大量淋巴细胞浸润,血管增生和纤维化。该病对放疗和激素敏感,局限型者…     

头颈部多发性Kimura病的临床与病理分析

Kimura病是临床少见的一种主要累及头颈部浅表淋巴结和软组织的局部慢性肉芽肿性病变。该病由Kim等于1937年以“嗜酸性细胞增多性淋巴肉芽肿”首次报道并予论述。1948年，Kimura等以“伴有淋巴组织增生的特殊肉芽肿”对本病作了较系统的描述．故本病又叫金氏病或木村病。该病病因不明、临床少见。因此临床医生对该病往往认识不足，临床易误诊且复发率高。     

嗜酸性淋巴肉芽肿四例误诊报告

嗜酸性淋巴肉芽肿四例误诊报告湖北医科大学口腔医学院·口腔医院（邮４３００７０）江波，赵怡芳嗜酸性淋巴肉芽肿亦称嗜伊红细胞增生性淋巴肉芽肿，是一种好发于颌面部软组织和淋巴结的肉芽肿性疾病，临床上易误诊为肿瘤等病奕。现就我科４例误诊病例报告如下，并对有关...     

右侧腮腺区Kimura病1例

Kimura＇s病是一种罕见病因不明的良性疾病,1984年Kimura等描述其为一种不寻常的肉芽组织伴淋巴组织增生变化。该病多见于亚洲人群,多发于头颈部,表现为区域性淋巴结肿大,很少自行消失,但未曾报道有恶变倾向。     

Differential diagnosis of immunoglobulin G4-related sialadenitis and Kimura’s disease of the salivary gland: a comparative case series

The aim of this study was to investigate key points for the differential diagnosis of immunoglobulin G4-related sialadenitis (IgG4-RS) and Kimura’s disease (KD) involving the salivary glands. The clinical, serological, radiological, histological, and immunohistochemical features of 85 IgG4-RS cases and 52 KD cases were evaluated comparatively. Seventy-two IgG4-RS cases had enlargement of multiple salivary and/or lacrimal glands; 67 patients had bilateral submandibular gland (SMG) involvement. Unilateral parotid gland involvement (59.6%) and comorbid skin lesions (61.5%) were common in KD. Serum IgG4 was elevated in 94.1% of IgG4-RS cases versus 19.0% of KD cases (cut-off value = 266.5 mg/dl). KD was more commonly associated with elevated eosinophil counts (86% vs 23.1%) and elevated IgE concentrations (95.5% vs 76.6%). Storiform fibrosis, irregular lymphoid follicles, and increased IgG4-positive cells (112.9 ± 37.6/high-power field (HPF)) were common in IgG4-RS. Acellular fibrosis, regular lymphoid follicles, IgE-positive reticular networks, increased IgE-positive cells (43.4 ± 26.7/HPF), and tryptase-positive mast cells (29.7 ± 13.3/HPF) were usually detected in KD. Computed tomography showed that 85.7% of KD cases involved subcutaneous fat tissue. A superficial hypoechoic and reticular pattern with multiple hypoechoic foci were the sonographic features of the SMG in IgG4-RS. Despite numerous overlapping manifestations, histopathological examination showed meaningful differences in the types of fibrosis, eosinophils, and IgG4-positive cell counts. Comprehensive evaluation of clinical, serological, radiological, and histopathological features are crucial for the differential diagnosis.     

Oral koilocytic dysplasia: long-term clinical control. A case report

Leukoplakia, a common lesion in the oral cavity, is considered a premalignant lesion that can develop into carcinoma. In 1986, a group of pathologists described a variant of epithelial dysplasia and named it "koilocytic dysplasia" (KD). This article presents a case of KD that was identified for 12 years as "carcinoma in situ". Even after removal of the lesion, it recurred with no signs of malignancy. The histopathological findings revealed all of the signs of KD (koilocytosis, acanthosis, multinucleated keratinocytes and atypical mitoses). Liquid-based cytology and hybrid capture were performed to confirm the diagnosis. Despite a professional recommendation to have the lesion removed surgically, the patient chose periodic clinical control. The mechanism of HPV transmission in the oral cavity still remains partially unknown. Additional studies on this subject are required to better understand the role of HPV in cell transformation in the oral cavity.     

Recurrent lip swelling as a late presentation of Kawasaki disease: Case report and review of literature

Kawasaki Disease (KD) is an acute systemic vasculitis of unknown etiology. In many developed countries, KD has replaced rheumatic heart disease as the leading cause of acquired heart disease in children. Among the classical criteria for a diagnosis of KD are oral manifestations such as strawberry tongue, erythematous cracked lip, and oropharyngeal mucositis. We report the case of a 24-year-old Saudi female with a history of Kawasaki disease who presented to our oral medicine clinic with recurrent painless swelling of the upper lip. As lip swelling has not previously been reported as an oral manifestation of KD, this case represents a novel presentation of recurrent Kawasaki disease in an adult female.     

Binding in vitro of vasoactive intestinal peptide on isolated acini of rat parotid glands

Binding of 125I-labelled vasoactive intestinal peptide (VIP) to rat parotid acini was saturable, temperature-dependent and reversible, and reflected interaction with a single class of binding sites. Parotid glands possessed approx. 400 fmol binding sites per mg protein and binding of the tracer to these sites could be inhibited by VIP [concentration for half-maximal effect (KD), 24 nM], by the peptide histidine isoleucine (KD, 140 nM), by secretin (KD, 470 nM) and by the human pancreatic growth hormone-releasing factor (hpGRF; KD, 3200 nM). In the same acini preparation, 10 microM VIP also stimulated amylase release 4-fold and increased cyclic AMP 11-fold. Thus, VIP might be a neurotransmitter in the rat parotid gland.     

Angiolymphoid hyperplasia with eosinophilia masquerading as Kimura disease

Angiolymphoid hyperplasia with eosinophilia is a rare benign vasoproliferative disease of unknown cause, which can present as tumour-like nodules in the head and neck. We treated a patient who showed some of the features of Kimura disease (KD), which is an important differential diagnosis, because of the latter's association with renal disease.     

Kimura病临床表现与病理(附5例报告)

目的对5例Kimura病(Kimura's disease,KD)的临床表现与病理特点进行初步分析,为临床医生诊断和鉴别诊断提供参考。方法5例均经手术肿块切除后,主要依据KD的组织病理学特点,结合流行病学和临床表现确诊。结果本文5例均为男性,平均36岁,出生地多在我国北方地区,主要表现为颌下、腮腺及耳后区的慢性无痛性肿块。5例外周血检查中,4例嗜酸性粒细胞增高,占白细胞总数的23%～48%,1例正常。5例病理基本特点:许多淋巴滤泡形成和薄壁血管增生,周围密集的嗜酸性粒细胞浸润,间质有明显纤维化,可见有嗜酸细胞性微脓肿。结论掌握KD临床表现和组织病理学特点,对于提高临床医生的诊断及鉴别诊断能力是很重要的。     

Oral necrotizing microvasculitis in a patient affected by Kawasaki disease

Kawasaki disease (KD) was first described in 1967 by Kawasaki, who defined it as "mucocutaneous lymph node syndrome". KD is an acute systemic vasculitis, which mainly involves medium calibre arteries; its origin is unknown, and it is observed in children under the age of 5, especially in their third year. The principal presentations of KD include fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Within KD, oral mucositis - represented by diffuse mucous membrane erythema, lip and tongue reddening and lingual papillae hypertrophy with subsequent development of strawberry tongue - can occur both in the acute stage of the disease (0-9 days), and in the convalescence stage (>25 days) as a consequence of the pharmacological treatment. KD vascular lesions are defined as systemic vasculitis instead of systemic arteritis. This study analyzed the anatomical-pathological substrata of oral mucositis in a baby affected by Kawasaki disease and suddenly deceased for cardiac tamponade caused by coronary aneurysm rupture (sudden cardiac death of a mechanical type).     

DNMT1干扰对唾液腺腺样囊性癌细胞系ACC-M E-cadherin表达的影响

目的：建立DNA甲基转移酶1（DNMT1）表达稳定抑制的唾液腺腺样囊性癌细胞系ACC-M,探讨DNMT1表达抑制对ACC-M细胞E-cadherin表达的影响。方法：设计靶向干扰DNMT1的shRNA序列,构建携带该序列的慢病毒载体并转导ACC-M细胞,对筛选出的抗性克隆采用RT-PCR、荧光定量PCR、免疫印迹方法分别检测DNMT1mRNA、蛋白质水平,筛选获得DNMT1表达稳定抑制的ACC-M细胞,并通过甲基化特异性PCR检测E-cadherin基因启动子的甲基化状态,荧光定量PCR检测E-cadherin的表达情况。采用SPSS11.0软件包对数据进行t检验。结果：筛选获得DNMT1稳定表达抑制的ACC-M细胞,其mRNA、蛋白相对表达水平（0.156±0.008,0.163±0.013）显著低于空白对照组和空载对照组。进一步检测发现,E-cadherin基因启动子甲基化水平明显降低,E-cadherinmRNA表达水平显著增高,P〈0.05。结论：shRNA慢病毒载体介导的RNA干扰能够有效、稳定地抑制ACC-M细胞DNMT1的表达,并降低ACC-M细胞E-cadherin基因启动子的甲基化水平,从而使E-cadherin基因表达增强。     

Kimura disease in the parotid gland

Kimura disease (KD) is a rare entity that occurs primarily in Asian people characterized histopathologically by a lymph-folliculoid granuloma with infiltration of the mass and the surrounding tissues by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E, generally seen in the head and neck region, especially preauricular area. In this article, we present the case of a 14-year-old male patient with KD on his left parotid area. The clinical, radiologic, surgical, and pathologic findings of KD are discussed in this article.