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The Korean Journal of Cytopathology 2003;14(2): 86-90.
Fine Needle Aspiration Cytology of Kimura's Disease of Parotid Gland: Report of A Case Cytologically Failed to Diagnose as Kimura's Disease.
Se Hoon Kim, Haeryoung Kim, Sung Eun Kim, Woo Ick Yang, Soon Won Hong, Kwang Gil Lee
1Department of Pathology, Yonsei University, College of Medicine, Korea. soonwonh@yumc.yonsei.ac.kr
2Department of Pathology, Yeongdong Severance Hospital Seoul, Korea.
3Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Kimura's disease is a chronic inflammatory disorder of unknown cause and is most prevalent among Asians. The cytologic findings of Kimura's disease are significant numbers of eosinophils in a background of lymphoid cells, occasional fragments of collagenous tissue, proliferation of vessels, and Warthin-Finkeldey polykaryocytes. Among these features, the most important cytologic feature of Kimura's disease is a significant numbers of eosinophils. We experienced a case of Kimura's disease in the parotid gland which we failed to recognize on cytology due to the apparent paucity of eosinophils. On careful retrograde reviewing of the cytologic findings, a few scattered leukocytes, previously interpreted as polymorphous leukocytes, had bilobed nuclei and coarse green but granular cytoplasm on Papanicolaou preparation. These leukocytes showed obvious orange-red intracytoplasmic granules as in eosionophils on Giemsa stain. The paucity of eosinophils may be due to the thick fibrosis around lymphoid follicles or any technical error during aspiration. Whereas the Warthin-Finkeldey type giant cell is not a sensitive cytologic marker of Kimura's disease, it may be a helpful cytologic feature. To reach a correct cytologic diagnosis of Kimura's disease, it is important to keep in mind that searching for Warthin-Finkeldey type giant cells and evaluation of Giemsa stain for detection of eosinophils would be helpful.
Key Words: Fine needle aspiration cytology; Parotid; Kimura's disease