Abstract
Kimura’s disease is a relatively rare benign disease of unknown etiology, associated with a painless mass usually arising in the subcutaneous soft tissue of the head and neck. We report a case suspected as the initial lesion of Kimura’s disease arising in buccal region of a 31-year-old man, who admitted to our hospital because of a painless mass in the left cheek. The mass was elastic soft with a clear margin under the buccal mucosa. T2-weighted magnetic resonance imaging showed a slightly low density mass in the buccal fat. There were no abnormal findings on peripheral blood examinations. The lesion was surgically excised with the patient under general anesthesia for the clinical diagnosis of a benign tumor. Histopathological examination of the tumor demonstrated many lymphoid follicles in the adipose tissue. Some of germinal centers in the follicles showed IgE deposition. Interfollicular fibrosis was present, and the adipose tissue was infiltrated by eosinophils as well as lymphocytes, plasma cells, and mast cells. These findings suggested an early lesion of Kimura’s disease. The peripheral blood examination showed that the number of eosinophils had increased to the upper limit of normal. The postoperative course was uneventful, and there has been no recurrence as of more than 1 year after operation without any additional treatment, but further follow-up is necessary.
