title: Head and neck lesions of Kimura's disease: exclusion of human herpesvirus-8 and Epstein-Barr virus by in situ hybridisation and polymerase chain reaction. An immunohistochemical study.
abstract: BACKGROUND
  Kimura's disease (KD) is a chronic inflammatory disorder, characterised by tumour-like lesions in the head and neck region, producing salivary gland nodules and lymph node enlargement. Many authors suggest that KD is a reactive immunological disorder; however, its aetiology remains unknown.
  
  
  OBJECTIVE
  To study immunohistochemical characteristics of head and neck lesions of KD (H&N-KD) and to investigate the possible role of human herpesvirus-8 (HHV-8) and Epstein-Barr virus (EBV) in the development of H&N-KD.
  
  
  METHODS
  This study enrolled five H&N-KD specimens from three patients treated between 1995 and 2005 at Pitié-Salpêtrière University Hospital, Paris, France. Immunohistochemical studies were performed on formalin-fixed, paraffin-embedded tissue. HHV-8 DNA was determined by polymerase chain reaction (PCR) analysis, whilst EBV sequences were identified by PCR and in situ hybridisation.
  
  
  RESULTS
  The immunohistochemical studies revealed CD20+ germinal centres with prominent staining of CD23+ dendritic reticular cells, surrounded by numerous interfollicular CD3+, and CD4+ or CD8+ T-cells. Factor VIII-related antigen, CD31 and CD34 occurred in the thin-walled blood vessels. The reactivity of CD1a, HHV-8 and EBV-associated latent membrane protein 1-EBV (LMP1-EBV) were negative, and in situ hybridisation confirmed the lack of EBV DNA. No patient recalled an external insult or chronic irritation.
  
  
  CONCLUSIONS
  The results of this study indicate the reactive nature of H&N-KD (or a subset of H&N-KD), and it is unlikely that HHV-8 and EBV play a role in the pathogenesis of the lesion. However, the patients in this series did not have previous history of trauma or chronic irritation; thus, a neoplastic origin could not be excluded. Further multicentre studies based on more specimens are warranted.
authors.affiliation: Department of Maxillofacial Surgery, AP-HP, Pitié-Salpêtrière University Hospital Faculty of Medicine, University Paris 6 Pierre et Marie Curie, Paris, France. poramate.pitakarnnop@gmail.com
authors.forename: Poramate
authors.initials: P
authors.lastname: Pitak-Arnnop
authors.forename: Salima
authors.initials: S
authors.lastname: Bellefqih
authors.forename: André
authors.initials: A
authors.lastname: Chaine
authors.forename: Kittipong
authors.initials: K
authors.lastname: Dhanuthai
authors.forename: Jacques-Charles
authors.initials: JC
authors.lastname: Bertrand
authors.forename: Chloé
authors.initials: C
authors.lastname: Bertolus
mesh_terms: D000328:Adult; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000276:immunology / Q000473:pathology / Q000821:virology*; D015703:Antigens, CD / Q000276:immunology; D006257:Head / Q000473:pathology; D006566:Herpesviridae Infections / Q000276:immunology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification*; D019288:Herpesvirus 8, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009333:Neck / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D015703:Antigens, CD