KIMURAS-DISEASE AND ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA - NEWOBSERVATIONS FROM IMMUNOHISTOCHEMICAL STUDIES OF LYMPHOCYTE MARKERS, ENDOTHELIAL ANTIGENS, AND GRANULOCYTE PROTEINS

Kimura's disease (KD) typically presents as large subcutaneous masses in young Oriental males. It is characterized by deep inflammation with vascular proliferation, lymphocytic nodules with subcutaneous germina l centers, fibrosis, and edema. In comparison, angiolymphoid hyperplas ia with eosinophilia (AHLE) occurs in all races and the lesions usuall y are smaller and more superficial. The causes of these two diseases a re debated. We compared histologic features of 4 cases of KD with 22 c ases of ALHE and studied expression of endothelial antigens and lympho cyte markers as well as localization of eosinophil, mast cell, and neu trophil granule proteins in lesional tissue. T-cell lymphoid aggregate s with well-formed B-cell germinal centers occurred in KD, and nodular and diffuse T-cell infiltration with small B-cell clusters occurred i n ALHE. Endothelial proliferation was more pronounced in KD, lacking t he atypical histiocytoid endothelial cells characteristic of ALHE. Man y intact eosinophils infiltrated lesions in both diseases, although KD had less extracellular granule protein deposition than ALHE. Intact m ast cells were seen in both diseases. There was neutrophil elastase st aining of occasional scattered intact cells but no extracellular depos ition. Compared with KD, ALHE is more varied in its clinical, histopat hologic, and immunohistochemical features.