Kimura Disease of Head and Neck

頭頸部的木村氏症

李兆翔(Chao-Hsiang Lee) ； 戴浩志(Hao-Chih Tai) ； 吳木榮(Mu-Zon Wu) ； 湯月碧(Yueh-Bih Tang) ； 陳明庭(Ming-Ting Chen) ； 謝孟祥(Mon-Hsian Hsieh)

《中華民國整形外科醫學會雜誌》 18卷3期 (2009/09) Pp. 199-208

https://doi.org/10.7096/JPSA.200909.0199

摘要

背景：
木村氏症是一種罕見的慢性發炎疾病，目前它的病因還不清楚。此病好發於頭頸部的皮下組織，也常見局部淋巴結和唾液腺的侵犯。
目標：
本篇文章主要目的是分析和提出本院案例的臨床表現以及文獻的回顧。
材料和方法：
我們收集以及分析了從1996年到2005年十年間本院一共16個案例，其中14位是男性，2位是女性。另外我們利用醫學資料庫(1966-2006)回顧了關於木村氏症的文章並且和我們的案例做比較。
結果：
病灶可能是單一處或是多處，大多分布在頭頸部，其中包含淋巴結，皮下組織，唾液腺，單獨或是合併表現。大多的病人都有血液中嗜伊紅性白血球增加的狀況，不過並沒有合併腎臟病變。所有病人都接受過至少一次的手術其中有5位有使用口服類固醇。在追蹤的過程中有5位有復發的狀況。
結論：
本院案例的臨床表現以及病理組織和文獻回顧上並無太大差異，除了復發機會較高以外，總括來說木村氏症的預後良好。在它的發病原因尚未明朗前治療方法依然還是個難題。依我們本院經驗，縱使復發機會不低，如果腫瘤切除是可行的，尤其是腫瘤已經影響到外觀的話，腫瘤完全切除手術還是比較好的選擇。如果是在頭頸部廣泛分布或是重覆復發的狀況，較保守的外科切除仍是它的第一個選擇。

並列摘要

Background:
Kimura disease is a rare form of chronic inflammatory disorder with unknown etiology. It occurred at subcutaneous tissues, predominantly in the head and neck region and frequently associated with regional lymphadenopathy and salivary gland in the East.
Aim and Objectives:
The purpose of this paper is to present clinical picture of our cases with literatures review.
Materials and Methods:
We reported and analyzed 16 cases of Kimura disease from 1996 to 2005 in our hospital, including 14 males and 2 females. Besides, a review of publications in English or Chinese (MEDLINE 1966-2006) as Kimura ('s') disease was performed and compared to our series.
Results:
The disease presented as either single or multiple lesions over head and neck region, and mainly involved lymph nodes, subcutaneous tissues, and major salivary glands in isolation or in combination. Most cases had peripheral blood eosinophilia but no renal involvement was found. All patients have received at least tumor excision once and oral steroid were used in 5 patients. Follow-up data showed recurrence on 5 patients.
Conclusion:
The clinical presentation and histopathology of our cases is in accordance with other Kimura cases reported in the literatures and the overall prognosis of Kimura disease is good except high recurrent rate. It remains a therapeutic enigma until its pathogenesis is resolved. In our opinion, complete surgical excision whenever feasible is the preferred treatment despite a not low recurrence rate, especially when the lesions are disfiguring. In the case of head and neck diffuse infiltrating or repeated recurrence, conservative surgical excision is also the first choice.

並列關鍵字

Kimura disease ； head and neck tumor