Kimura Hastalığı Lenfadenopatisi
Özet
Kimura hastalığı, subkutan doku ve lenf nodlarını tutan kronik inflamatuar bir hastalıktır. Asya toplumlarında ve genç erişkin erkeklerde daha sık görülür. Kimura hastalığı lenfadenopatisi, genellikle baş-boyun bölgesi lenf nodlarında ağrısız kitle olarak başlangıç yapar. B semptomları nadirdir. LAP yavaşça büyür ve uzun yıllar durağan seyreder. Tedavide en iyi sonuçlar cerrahi rezeksiyon ve post-op radyoterapi kombinasyonu ile elde edilir. Laboratuvar testlerde eozinofili ve IgE yüksekliği en önemli bulgulardır. Lenf nodu histopatolojik değerlendirmesinde en tutarlı bulgular foliküler hiperplazi, diffüz parafoliküler eozinofilik infiltrat, postkapiller venül proliferasyonu ve perivenüler sklerozdur. Germinal merkezlerde eozinofilik mikroabseler, foliküler lizis ve İgE agregatları diğer önemli histolojik bulgulardır. Ayırıcı tanıda; anjiolenfoid hyperplasia with eosinophili, klasik hodgkin lenfoma, miks selüler tip, castleman hastalığı, hyalin vasküler tip, langerhans hücreli histiyositoz, parazitik enfeksiyonlar, ilaç reaksiyonları, anjioimmünoblastik t hücreli lenfoma, dermatopatik lenfadenopati, IgG4 ilişkili lenfadenopati yer alır.
Kimura disease is a chronic inflammatory disease affecting the subcutaneous tissue and lymph nodes. It is more common in Asian populations and young adult males. Kimura disease lymphadenopathy usually begins as a painless mass in the lymph nodes of the head and neck region. B symptoms are rare. The lymphadenopathy grows slowly and remains stable for many years. The best results in treatment are obtained with a combination of surgical resection and postoperative radiotherapy. Eosinophilia and elevated IgE levels are the most important findings in laboratory tests. The most consistent findings in lymph node histopathological evaluation are follicular hyperplasia, diffuse parafollicular eosinophilic infiltrate, postcapillary venule proliferation, and perivenular sclerosis. Eosinophilic microabscesses in germinal centers, follicular lysis, and IgE aggregates are other important histological findings. In differential diagnosis; Angiolymphoid hyperplasia with eosinophilia, classic Hodgkin lymphoma, mixed cellular type, Castleman disease, hyaline vascular type, Langerhans cell histiocytosis, parasitic infections, drug reactions, angioimmunoblastic T-cell lymphoma, dermatopathic lymphadenopathy, and IgG4-related lymphadenopathy are among the causes.
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