木村氏病－十二例分析

背景及目的：木村氏病(Kimura's disease)是一種罕見的慢性發炎疾病，病因不明，主要的特徵是皮下腫塊，頭頸部是好發部位，尤其是唾液腺。好發於亞裔年輕至中年男性，臨床上可見局部淋巴結腫大，實驗室檢查多有週邊血液嗜伊紅性白血球升高及IgE上升。木村氏病在臺灣過去雖有零星報導過，但因為非常罕見，一般耳鼻喉科醫師對其並不熟悉。本研究旨在描述一群以頭頸部腫塊為主要初始表現的木村氏病患者，並探討其處理原則。方法：本研究乃收集1990年1月至2004年10月，於本院診治之木村氏病患者中，總共12名，回溯整理其病歷記錄，並追蹤後續的併發症。結果：12名病患中，男性10名，女性2名。平均年齡38歲（5歲到72歲）。皮下腫塊分布位置以腮腺5名最多，大部份的患者都有週邊血液嗜伊紅性白血球升高的現象（10名患者中有8名）。全部的患者在初次發病時都接受手術切除腫塊，追蹤期間（2個月至7年3個月），其中7名患者仍然有皮下腫塊（包括5名復發），4名患者沒有再罹患該疾病，有1名患者失去追蹤。3名患者有腎臟的疾病，而其中2名須接受透析治療。討論：對於以頭頸部皮下腫塊為初始表現的年輕至中年男性患者，若合併有週邊血液嗜伊紅性白血球升高及IgE上升，應將木村氏病納入鑑別診斷之中，術後長期的追蹤也是必須的。

關鍵字

木村氏病；淋巴腺病變；嗜伊紅性白血球升高

並列摘要

Background: Kimura's disease is an allergic, inflammatory disorder of unknown cause. The typical presentation is in a young to middle-aged Oriental male with nontender subcutaneous swellings in the head and neck region, lymphadenopathy, peripheral eosinophilia, and elevated serum IgE. To better characterize Kimura's disease in Taiwan, we conducted this retrospective study. Methods: Between January 1990 and October 2004, we reviewed the medical records of all patients with the final diagnosis of Kimura's disease. Twelve patients with the initial presentation of head and neck mass for which a diagnosis of Kimura's disease was established later were enrolled in this study. Results: There were 10 males and 2 females, age range from 5 to 72 years old (mean, 38 years). The most common anatomic sites of involvement included infra-auricular area (n=7), retroauricular area (n=3) and cervical posterior triangle (n=3). Most (n=10) patients had peripheral blood eosinophilia. Follow-up data on 11 patients revealed that 4 were alive without disease and 7 were alive with disease (5 had recurrence). Three patients had renal disease and two of them underwent dialysis. Conclusion: If a young man has a painless indolent mass over the head and neck region and laboratory data reveals peripheral blood eosinophilia and elevated IgE level, Kimura's disease should be considered.

並列關鍵字

Kimurazs disease ； lymph adenopathy ； eosinophilia

國際替代計量

木村氏病－十二例分析

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