case_images: PMC6937823_01
case_images: Ultrasonography showing enlarged lymph nodes bilaterally
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case_images: PMC6937823_01_13223_2019_400_Fig1_HTML.jpg
case_images: Fig1
case_images: Enlargement of multiple lymph nodes was found in all areas (Fig. 1).
case_images: Ultrasonography showing enlarged lymph nodes in right parotid gland and back neck
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case_images: PMC6937823_01_13223_2019_400_Fig2_HTML.jpg
case_images: Fig2
case_images: Many solid nodules with a maximum size of 2.7 x 1.6 cm2 and 1.9 x 0.6 cm2 were found in the right parotid gland and right posterior neck, respectively (Fig. 2).
case_images: Histological features of excisional biopsy demonstrating eosinophilic infiltration. a Kimura Lymphadenopathy. Lymphoid follicle wth reactive germinal center (upper right), Intense eosinophilia with formation of eosinophilic microabscess(lower left). (H&E stain, x100). b Same lymph node. Diffuse eosinophilia with capillary hyperplasia. (H&E stain, x100). c Same lymph node. Eosinophilic microabscess formation with hyperplasia of endothelial cells in postcapillary venules. (H&E stain, x400)
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case_images: PMC6937823_01_13223_2019_400_Fig3_HTML.jpg
case_images: Fig3
case_images: Postoperative pathological findings showed KD in the right neck, left chest wall, and left axillary lymph nodes (Fig. 3).
case_images: Immunohistochemical stains of excisional retroauricular lymph node shows reactive hyperplasia expression form. (EnVision two-step stain, x40). a CD3 is expressed by numerous T cells located in interfollicular zone, fewer T cells in follicular germinal center, mostly of Th cells, b CD20 is expressed by abudantly hyperplastic reactive Lymphoid follicles, c CD21 highlights nodular FDC network. d BCL-2 stainning shows the germinal center of hyperplastic follices negative, but mantle zone of follicles and interfollicular zone positive, e Ki-67 stainning indicates the proliferation index of lymphocytes in germinal center of secondary follicular germinal centers high expression
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case_images: PMC6937823_01_13223_2019_400_Fig4_HTML.jpg
case_images: Fig4
case_images: T lymphoid tissue suggested CD2, CD3, CD5, CD7, CD4, and CD8 positivity; BCL-6, CD10, and PD-1 negativity; no identified Reed-Sternberg (RS)-like cells (CD15 and CD30 negative) and proliferation of follicular dendritic cells (FDCs); and a nodular FDC network for CD21 (Fig. 4). The final diagnosis for this patient was KD.