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SKINDIA QUIZ
Year : 2018  |  Volume : 9  |  Issue : 4  |  Page : 282-283  

SkinIndia Quiz 46: Asymptomatic unilateral inguinal swelling with peripheral eosinophilia


1 Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
2 Department of Dermatology, Venereology and Leprosy, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India
3 Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Date of Web Publication2-Jul-2018

Correspondence Address:
Surabhi Sinha
Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, Baba Kharak Singh Marg, New Delhi - 110001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_181_17

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How to cite this article:
Tandon S, Singh J, Sinha S, Sharma P. SkinIndia Quiz 46: Asymptomatic unilateral inguinal swelling with peripheral eosinophilia. Indian Dermatol Online J 2018;9:282-3

How to cite this URL:
Tandon S, Singh J, Sinha S, Sharma P. SkinIndia Quiz 46: Asymptomatic unilateral inguinal swelling with peripheral eosinophilia. Indian Dermatol Online J [serial online] 2018 [cited 2019 Oct 18];9:282-3. Available from: http://www.idoj.in/text.asp?2018/9/4/282/231793

Clinical History and Examination

A 50-year-old male presented with right-sided inguinal swelling [Figure 1] for the past 1 year. Previously, the patient was clinically diagnosed as a case of tubercular lymphadenopathy and had received 6 months of antitubercular therapy without any noticeable improvement. Cutaneous examination revealed a single, mobile, firm, nontender, matted, irregular mass of size 6 Χ 6 cm in the right inguinal regional with normal overlying skin. Blood investigations showed peripheral eosinophilia (52%) with an absolute eosinophil count of 4500/mm3 and normal erythrocyte sedimentation rate. A regional fine needle aspiration cytology showed features of reactive lymphoid hyperplasia. The results of renal function tests, liver function tests, and routine urine tests were within normal limits, and chest radiography was unremarkable. Mantoux test was 5 × 5 mm.
Figure 1: Photograph shows right-sided inguinal swelling

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Histopathology

A lesional biopsy revealed preserved architecture of lymphoid follicles with prominent germinal centers. Interfollicular areas showed prominence of eosinophils

and plasma cells along with the presence of an occasional multinucleate giant cell [Figure 2]. Eosinophils were also seen infiltrating into lymphoid follicles and the capsule, with proliferation of capillaries and venules [Figure 3]. Stains and cultures were negative for bacteria, fungi, and mycobacteria.
Figure 2: Photomicrograph shows presence of sheets of eosinophils along with admixed plasma cells. Occasional multinucleated giant cell is also noted (H and E ×200).

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Figure 3: Higher magnification shows a mixed population of eosinophils and plasma cells intermixed with mature lymphoid tissue (H and E ×400)

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What is Your Diagnosis?



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   References Top

1.
Takagi K, Harada T, Ishikawa E. Kimura's disease eosinophilic: lymphfolliculoid granuloma. Nihon Rinsho 1993;51:785-8.   Back to cited text no. 1
    
2.
Kuo T, Shih L, Chan H. Kimura's disease. Involvement of regional lymph nodes and distinction from angiolymphoid hyperplasia with eosinophilia. Am J Surg Pathol 1988;12:843-54.   Back to cited text no. 2
    
3.
Chen H, Thompson LD, Aguilera NS, Abbondanzo SL. Kimura disease: A clinicopathologic study of 21 cases. Am J Surg Pathol 2004;28:505-13.   Back to cited text no. 3
    
4.
Lenk N, Artüz F, Kulaçoğlu S, Alli N. Kimura's disease. Int J Dermatol 1997;36:437-9.   Back to cited text no. 4
    
5.
Diwan AW, Godbole GP, Pophale HS, Kulkarni SR. Unusual presentation of Kimura's disease. Saudi J Med Sci 2014;2:52-6.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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