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1/12. Kimura's disease: a case report and literature review.

    Kimura's disease, which occurs endemically in the far east and sporadically in the West, has so far eluded efforts to determine its exact pathogenesis. It presents as solitary or multiple benign swellings of the skin, has a predilection for the periauricular and scalp regions, and often is associated with regional lymphadenopathy. Morphologically, the lesions are characterized by proliferating blood vessels with rich eosinophilic infiltrate. Peripheral blood eosinophilia and raised serum IgE levels are signature features of the condition. The overall prognosis is good. When surgery is not possible, conservative treatment with either corticosteroids or radiation often can produce a favorable response. Complete surgical excision whenever feasible is the preferred treatment despite a high recurrence rate. Based on a recent case of Kimura's disease in a 55-year-old black woman, we discuss the pitfalls in the diagnosis of this chronic inflammatory disorder.
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2/12. Unilateral angiolymphoid hyperplasia with eosinophilia involving the left arm and hand.

    A case report of recurrent angiolymphoid hyperplasia with eosinophilia (ALHE) in an otherwise healthy 20-year-old female with manifestation of the disease limited to the left arm and hand is presented together with brief evaluation of the literature as well as the features distinguishing ALHE and Kimura's disease. Immunohistochemical investigations support the hypothesis that ALHE represents a reactive inflammatory lesion rather than a benign vascular neoplasm. A viral cause of ALHE (e.g., HHV8 or Epstein-Barr virus (EBV)) could not be demonstrated. The recurrent nature of the disease is shown by this case, which also demonstrates the need for frequent medical and surgical management.
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3/12. Kimura's disease in a chronic hemodialysis patient.

    Eosinophilia is not an uncommon finding in chronic dialysis patients. It is usually benign in nature although definite pathogenesis is unknown. We have encountered a young uremic Chinese adult who developed Kimura's disease after being on maintenance hemodialysis for about 3 years. Asymptomatic eosinophilia had been noted for 1 year and 8 months prior to the development of progressively enlarged neck masses, which leads to the diagnosis of Kimura's disease. In contrast to most cases, eosinophilia was first noticed before the neck masses appeared. There is often a close correlation between Kimura's disease and glomerular disease, where renal involvement is considered as a systemic manifestation. However, we do not have strong evidence to support this relationship between terminal renal failure and Kimura's disease in this patient. To our knowledge, our patient is the first reported case of Kimura's disease occurring in chronic hemodialysis patients. Eosinophilia persisted for nearly 2 years before the neck mass developed and recurred after the excision. Besides, our patient also demonstrated a chronic and recurrent course typical of Kimura's disease.
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4/12. angiolymphoid hyperplasia with eosinophilia arising from the facial artery.

    We report on a rare case of angiolymphoid hyperplasia with eosinophilia (ALHE) arising from the facial artery, which was pre-operatively diagnosed as an aneurysm. ALHE is a rare lesion, the precise nature of which remains controversial: it is still unclear whether ALHE is a tumour or an inflammatory disease or whether it can be separated from Kimura's disease based on its pathological characteristics. ALHE rarely occurs in muscular arteries, and this is the first description of ALHE arising from the facial artery. angiography vividly revealed the pathological structure of the lesion in this case, which prompted us to advocate angiography for diagnosing ALHE arising from muscular arteries. Complete dissection and cryotherapy proved to be effective treatment, although complete management of any therapeutic protocol should avoid recurrence of the lesion, whatever specific treatments are selected.
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5/12. angiolymphoid hyperplasia with eosinophilia: a rare artery lesion.

    BACKGROUND: angiolymphoid hyperplasia with eosinophilia (AHE) is a rare skin condition of unknown aetiology. The lesion seems neoplastic in nature, or at least an abnormal vasoproliferative reaction. CASE REPORT: A 40-year-old man presented with an 18-month history of erythematous papula over the right temporal area without a history of trauma. The patient reported a history of Hodgkin lymphoma at the age of 20, treated by radiochemotherapy. A subcutaneous nodule was found on the superior branch of the right temporal artery. An echocolordoppler revealed a normal temporal artery flow with pariental thickness. An excisional biopsy was performed and the patient remained asymptomatic at 24 months. The histological diagnosis was angiolymphoid hyperplasia with eosinophilia of the temporal artery. CONCLUSION: More appropriate studies are necessary to assess whether AHE is a manifestation of an unknown immunological disorder. If a correlation could be found between an altered immunological system and AHE, an intensive follow-up could be applied to patients. We report this case to encourage further studies to highlight potential challenges in the diagnosis and management of variants of vascular processes, such as AHE.
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6/12. angiolymphoid hyperplasia with eosinophilia involving the cubital nerve.

    A tumor involving cubital nerve was resected and studied; it was classified as an angiolymphoid hyperplasia with eosinophilia (ALHE). Immunohistochemical and molecular study was done both to confirm the reactive nature of the process and rule out the presence of clonal T or B cell rearrangement. This lesion has been designated as epitheloid hemangioma [Coindre (1994) Ann Pathol 14:426]. Typically, ALHE occurs in the skin and the subcutaneous tissue, and extracutaneous involvement is rare. No cases of ALHE affecting a nerve have been described, but a case of Kimura's disease, the lesions of which have repeatedly been confused with ALHE, has been reported involving median nerve.
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7/12. magnetic resonance imaging findings in Kimura's disease.

    Although early diagnosis of Kimura's disease, a rare chronic inflammatory disorder most commonly presenting with asymmetric swelling in the head and neck region, is helpful in avoiding unnecessary diagnostic tests and starting prompt treatment, only a few reports emphasized radiological findings in detail. magnetic resonance imaging findings showing the infiltrative nature of the disease and diffuse loss of fat tissue even in nonpalpable normally appearing regions of the head and neck in a young man with Kimura's disease are presented in this report.
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8/12. Kimura's disease and membranous nephropathy.

    An interesting association of Kimura's disease and membranous nephropathy is reported in a 71-year-old Chinese patient, 40 years after emigrating to the UK from hong kong. Significant blood eosinophilia and a very high serum IgE level were detected, the latter with a moderate level of specificity to candida albicans. light microscopy of renal biopsy was unremarkable despite a proteinuria of nephrotic proportions; diffuse subepithelial dense deposits compatible with membranous nephropathy were identified on electron microscopy. The atopic nature of Kimura's disease is confirmed and C. albicans is suggested as a possible causative agent.
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9/12. Nodal angiolymphoid hyperplasia with eosinophilia.

    angiolymphoid hyperplasia with eosinophilia (AHE) is a benign process of unknown origin that tends to mainly affect the skin and subcutaneous tissue. A case is presented of AHE arising in a lymph node in the absence of dermal or subcutaneous involvement. The unusual location and histologic characteristics of the lesion prompted an initial diagnosis of Hodgkin's disease. Follow-up and review of the biopsy at a later date disclosed the characteristic features of AHE. The present case illustrates the ubiquitous nature of this process. AHE should be included in the differential diagnosis in lymph nodes showing effacement of their architecture by a diffuse, predominantly eosinophilic cellular infiltrate.
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10/12. angiolymphoid hyperplasia with eosinophilia: report of a case arising from the radial artery.

    A case of angiolymphoid hyperplasia with eosinophilia arising from the radial artery is presented. Histologically, there was proliferation of atypical endothelial cells forming vascular spaces and solid cords, with a background infiltrate of inflammatory cells and prominent tissue eosinophilia. Immunohistochemical studies demonstrated vimentin and factor viii related antigen in the endothelial cells. The lymphoid infiltrate was polyclonal. These lesions, which typically occur in the dermis and subcutaneous tissue of the head and neck, are known by a variety of different names reflecting disagreement regarding their pathogenesis. The probable nature of the process is discussed.
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