Recurrent kimura disease of unilateral parotid gland: the magnetic resonance imaging findings.

Abstract

Kimura disease (KD) is a rare chronic inflammatory disorder, mainly seen in young Asian males, characterised by painless salivary gland swelling, lymphadenopathy, subcutaneous nodules in the head and neck and peripheral eosinophilia, likely due to an abnormal immune response. We report a case of an Indian male in his early 40s, presenting with a gradually enlarging, painless left parotid swelling for 6 months, without fever or trauma. He had undergone left parotid surgery 7 years ago, with histopathology confirming KD. Few palpable left cervical lymph nodes were also observed on examination. MRI showed an enlarged heterogeneous T2W and FLAIR hyperintense left parotid gland with intense post-contrast enhancement and enhancing ipsilateral cervical lymphadenopathy. MRI findings were indicative of an inflammatory lesion. Fine-needle aspiration cytology showed a benign lymphoid proliferation with marked eosinophilia, revealing recurrent KD. Combined therapy with oral prednisolone, cyclosporine and surgery led to significant improvement.