Isolated Cervical Lymph Node Kimura Disease in a Child Mimicking Tuberculosis: A Diagnostic Challenge.
Sudesh Kumar, Avinash Priyadarshi, Shreemant Gautam
✦ AI-curated · Sources linked
Case in brief
A 16-year-old boy presented with a progressive, painless left cervical nodular swelling, preceded by low-grade fever. Examination found cervical and axillary lymphadenopathy and icterus, without visceromegaly. The leukocyte count was 22,990/mm³, with eosinophils at 42.9%; serum IgE exceeded 4,000 IU/mL. Excisional biopsy showed hyperplastic lymphoid follicles, dense interfollicular eosinophils, eosinophilic microabscesses, and multinucleated giant cells, supporting cervical lymph node Kimura disease. He received oral prednisolone followed by tapering, and continued treatment for two months.
What made this case unusual
The child’s cervical lymphadenopathy raised concern for tuberculosis, while the marked eosinophilia, very high IgE, and eosinophil-rich biopsy supported Kimura disease—a diagnostic mimic in a pediatric presentation.
Diagnostic / clinical pearl
In a child with painless cervical soft-tissue swelling, marked eosinophilia and elevated serum IgE can support consideration of Kimura disease; excisional biopsy can establish the diagnosis.