• Users Online: 2069
  • Print this page
  • Email this page


 
  Table of Contents  
SKINDIA QUIZ
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 66-67  

SkIndia Quiz 8: Multiple subcutaneous swellings around the ears


Department of Dermatology, Command Hospital, Pune, India

Date of Web Publication3-Jan-2013

Correspondence Address:
Biju Vasudevan
Department of Dermatology, Command Hospital (Southern Command), Wanowrie, Pune
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.101816

Rights and Permissions

How to cite this article:
Vasudevan B, Verma R, Pragasam V, Moorchung N, Mitra D, Neema S. SkIndia Quiz 8: Multiple subcutaneous swellings around the ears. Indian Dermatol Online J 2013;4:66-7

How to cite this URL:
Vasudevan B, Verma R, Pragasam V, Moorchung N, Mitra D, Neema S. SkIndia Quiz 8: Multiple subcutaneous swellings around the ears. Indian Dermatol Online J [serial online] 2013 [cited 2019 Dec 15];4:66-7. Available from: http://www.idoj.in/text.asp?2013/4/1/66/101816

A 48 year old male presented with the complaint of lumps below and behind both the ears since nine years. The lumps were painless, insidious in onset and gradually progressive. There was no associated weight loss or other systemic symptoms. General and systemic examination revealed normal findings. Local examination revealed multiple nodules in the parotid and retroauricular regions bilaterally, which were soft to firm in consistency, non- tender, and were not fixed to the underlying structures or the overlying skin [Figure 1]. Multiple cervical lymph nodes were enlarged. The peripheral blood smear showed eosinophilia of 80% with absolute eosinophil count of 11,000/mm 3 . Serum Immunoglobulin E (IgE) was raised. Magnetic Resonance Imaging revealed bilateral parotid swelling with enlarged level I to V cervical lymph nodes bilaterally. Fine Needle Aspiration Cytology from cervical lymph node showed reactive lymphoid tissue.
Figure 1: Cutaneous lesions (a) Bilateral parotid swelling (b) Multiple nodules in right retro- auricular region

Click here to view


Biopsy from the right retroauricular nodule revealed multilobulated masses in the deep dermis [Figure 2]a. Within the lobules, there was proliferation of vessels surrounded by dense eosinophilic infiltrate. Lymphoid follicles with germinal centres and fibrinoid material within the germinal centres along with eosinophilic abscesses were present [Figure 2]b and [Figure 3]. Bilateral excision of the nodules was done 4 years back with skin grafting. However, the nodules recurred 6 months after surgery.
Figure 2: Histopathology revealing (a) Multiple lymphoid aggregates in dermis (H and E, 10x) (b) Follicular architecture with eosinophilic abscess (H and E, 10x)

Click here to view
Figure 3: Extensive eosinophilic infiltrate in the nodule (H and E, 40x)

Click here to view



   What is the Diagnosis? Top




Click here to view answer. View Answer


 
   References Top

1.Katagiri K, Itami S, Hatano Y, Yamaguchi T, Takayasu S. In vivo expression of IL-4, IL-5, IL-13 and IFN-c mRNAs in peripheral blood mononuclear cells and the effect of cyclosporin A in a patient with Kimura's disease. Br J Dermatol 1997;137:972-7.  Back to cited text no. 1
[PUBMED]    
2.Teraki Y, Katsuta M, Shiohara T. Lichen amyloidosis associated with Kimura's disease: Successful treatment with cyclosporine. Dermatology 2002;204:133-5.  Back to cited text no. 2
[PUBMED]    
3.Abuel- Haija M, Hurford MT. Kimura disease. Arch Pathol Lab Med 2007;131:650-1.  Back to cited text no. 3
    
4.Iwai H, Nakae K, Ikeda K, Ogura M, Miyamoto M, Omae M, et al. Kimura disease: Diagnosis and prognostic factors. Otolaryngol Head Neck Surg 2007;137:306-11.  Back to cited text no. 4
[PUBMED]    
5.Wang YS, Tay YK, Tan E, Poh WT. Treatment of Kimura's disease with cyclosporine. Journal of Dermatolog Treat 2005;16:242-4.  Back to cited text no. 5
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    What is the Diag...
   Answer
   Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed2182    
    Printed50    
    Emailed0    
    PDF Downloaded353    
    Comments [Add]    

Recommend this journal