Kimura病临床病理及发病学研究

目的 探讨Kimura病(Kimura’s Disease，KD)的临床病理特点，对其发病机理进行初步分析。方法 利用光镜，免疫组织化学及特殊染色方法观察8例KD病变组织中的C1320、CD45RO、CD21、CD35、IgE、IgA、IgM、IgG和肥大细胞，对所有病例的临床和实验室资料进行分析。结果 所有病例均为男性，年龄在13～36岁，平均年龄25岁，病变均位于头颈部。组织学上以小血管增生、大量嗜酸性粒细胞浸润、淋巴细胞增生及滤泡形成、纤维组织增生为基本病变。免疫组化显示病变组织中IgE明显增多，主要分布在淋巴滤泡生发中心内及生发中心外浆细胞内；肥大细胞大量增生。外周血IgE水平升高。术后随访，全部存活。结论 KD是一种具有特殊临床病理表现的良性病变，手术治疗后虽常复发，但预后良好。其发病可能与Ⅰ型变态反应有关。

A Clinicopathologic and Pathogenetic Study of Kimura''''s Disease

Objective To study the clinicopathologic feature and explore the pathogenesis of Kimura's Disease(KD). Methods Hematoxylin and eosin stain (HE),immunohistochemistry and histochemistry techniques were used on tissue arrays to show histological morphology and distribution of protein antigens. The clinical data were analyzed. Results All the patients are men.The patient's ages at diagnosis are 13 to 36, it has a predilection for head and neck region.Microscopically,characterized histologically by lymphatic follicles,vascular proliferation and marked eosinophilic infiltration. immmunohistochemically, IgE positive reactions were found in most of the germinal centers.Furthermore,some cells with IgE positive reactions in their membranes were also demonstrated,mast cells hyperplasia was seen.Surgical excision was used for all patients,who are alive but with disease at last follow-up. Conclusion KD has evident characteristics in age,sex,site and lesion duration. The clinical course is benign,though some cases may recur. It was suggested that Type I allergy might be the main pathogenesis.