Eosinophilic granuloma of soft tissue

(so called Kimura's disease) of the submental region: Report of a cace

Abstract

Eosinophilic granuloma, so called Kimura's disease, is a benign chronic granuloma that appears chiefly in subcutaneous soft tissue or lymphonodus such as face submandibular neck and inguinal regions.
Its pathological finding is characteristically neoplastic or hyperplastic lymphofollicular structure and infiltration of eosinophils. Also increased the serum IgE level. These findings suggest that this disease is conceivably a type I allergy.
We reported on a five-year-child who had an eosinophilic granuloma in the subcutaneous soft tissue of the submental region. He had a touch of cold 2 weeks before visiting our hospital. We found as leukocyte increase in the laboratory results and administered antibiotics. At that time his mother noticed the swelling of the submental region and watched its subsequent developments. The swelling did not decrease so she brought him to our hospital.
His general condition was good, but we noticed a sparrow's egg-size swelling at the submental region and bilateral submandibular lymphonodi. Blood analysis proved a leukocyte increase, and eosinophils reached 5 percent.
Clinically we diagnosed submental and mandibular lymphonoditis. We extracted two teeth that we suspected had caused the sweelling of the submental region and submandibular lymphonoditis and further administered antibiotics. Consequently the swelling subsided, but did not completely vanish. Then we carried out surgical extraction under general anesthesia.
Pathological findings showed a characteristic lymphofollicular structure and infiltration of eosinophils. Ten months after the operation, there is no symptom of recurrence.
As the literature we reviewed indicated that the frequency of recurrence when was high when treated by surgery alone, we recognized the necessity of careful follow-up thereafter.