Ultrasonographic findings of Kimura's disease presenting in the upper extremities.
OBJECTIVE
To describe ultrasound findings of Kimura's disease arising in the upper extremities.


METHODS
Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist.


RESULTS
All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis.


CONCLUSIONS
In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.
Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, 75 Bokjiro, Busanjin-gu, Busan, 614-735, Korea, mlvee@hanmail.net.
Gi Won
GW
Shin
Sun Joo
SJ
Lee
Hye Jung
HJ
Choo
Young Mi
YM
Park
Hae Woong
HW
Jeong
Sung-Moon
SM
Lee
Jin-Suck
JS
Suh
Soo-Jin
SJ
Jung
D000328:Adult; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000000981:diagnostic imaging*; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D034941:Upper Extremity / Q000000981:diagnostic imaging*