Kimura's disease: imaging patterns on computed tomography

Aim

To define the role of computed tomography (CT) in identifying and classifying the imaging patterns of diagnostic value in Kimura's disease of the head and neck.

Methods

A retrospective study was undertaken comprising 13 patients with histopathological evidence of Kimura's disease. The patients' clinical and pathological records were reviewed against a detailed analysis of their CT images performed from the base of the skull to the arch of the aorta.

Results

Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the subcutaneous tissue of the head and neck region. All patients had lesions adjacent to the major salivary glands. The parotid gland was affected in 10 of the 13 cases and the submandibular gland was affected in the rest. Contrast enhancement was variable. More than half of the cases had associated lymphadenopathy. Some of them showed atrophy of the skin and subcutaneous fat overlying the subcutaneous masses. Blood eosinophilia was a consistent feature in all the cases.

Conclusion

The patterns of distribution, morphology, and enhancement of the lesions in Kimura's disease that can be demonstrated at CT, enables a confident, non-invasive diagnosis of this condition, in an appropriate clinical context.