RESUMO
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare nodular mass that has not commonly been reported in the literature in association with coccidioidomycosis (CM). Coccidioidomycosis has other known skin manifestations including erythema nodosum and interstitial granulomatous dermatitis. Pulmonary CM is the most common form of the disease and the most common cause of CM-associated rash. This is an important clinical consideration for patients with ALHE who reside in CM-endemic areas, which notably include the southwestern region of the United States, Mexico, and South America. We report the case of an ALHE lesion that resolved following treatment for CM.
Assuntos
Hiperplasia Angiolinfoide com Eosinofilia , Coccidioidomicose , Hemangioma , Hiperplasia Angiolinfoide com Eosinofilia/complicações , Hiperplasia Angiolinfoide com Eosinofilia/diagnóstico , Hiperplasia Angiolinfoide com Eosinofilia/patologia , Coccidioidomicose/complicações , Coccidioidomicose/diagnóstico , Hemangioma/complicações , Humanos , MéxicoRESUMO
Kimura's disease (KD) is a rare chronic inflammatory disease of unclear etiology, characterized by subcutaneous nodules, mainly in the head and neck region, frequently associated with regional lymphadenopathy. Orbital involvement is infrequent and when it occurs, usually affects the eyelid or the lacrimal gland. We report a case of a 44-year-old man that presented with bilateral slowly progressive proptosis that was initially misdiagnosed as Graves' Ophthalmopathy. 15 months of worsening proptosis and the development of facial and temporal swelling led to further investigation. Computed tomography and magnetic resonance imaging showed enlargement of all recti muscles and diffuse orbital infiltration. An orbital biopsy was performed and was consistent with the diagnosis of KD. Long term oral corticosteroid showed marked improvement of proptosis and facial swelling. This case serves to emphasize that KD should be included in the differential diagnosis of inflammatory diseases of the orbit, even when characterized by predominant involvement of the extraocular muscles.
Assuntos
Hiperplasia Angiolinfoide com Eosinofilia/complicações , Erros de Diagnóstico , Exoftalmia/diagnóstico , Adulto , Hiperplasia Angiolinfoide com Eosinofilia/diagnóstico , Biópsia , Diagnóstico Diferencial , Exoftalmia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Músculos Oculomotores , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To present a case of Kimura disease associated with kidney epithelial neoplasia. Kimura disease is a rare inflammatory disease, which usually presents with enlarged lymph nodes and masses in the head and neck regions. The differential diagnosis should include lymphomas, reaction lymphadenopathy to drugs or parasites. Amid the masses and enlarged lymph nodes a nodule suggestive of neoplasm can be found. There is a case, in the literature that describes Kimura Disease associated with kidney neoplasm. METHOD: We present the case of a young female patient who showed intra and retroperitoneal nodulations, including one in the lower pole of left kidney. After the period of treatment with corticoids, computed tomography of abdomen confirmed the permanence of the lesion with features of malignancy. A partial left nephrectomy was performed, and postoperative evolution was favorable. RESULT: The patient is without signs of Kimura Disease and no signs of recurrence of the tumor after a period of 18 months from surgery. CONCLUSION: Kimura disease is associated with some neoplasias that should be investigated by the medical team. Partial nephrectomy seems a good therapeutic option for well-defined neoplastic nodules located on renal poles.
Assuntos
Hiperplasia Angiolinfoide com Eosinofilia/complicações , Neoplasias Renais/complicações , Feminino , Humanos , Adulto JovemRESUMO
A 13-year-old Brazilian boy with Kimura's disease (eosinophylic lymphoid granuloma) and nephrotic syndrome is reported. Native kidney biopsy showed focal segmental glomerulosclerosis (FSGS). Treatment with prednisolone resulted in partial remission of proteinuria, and he had a progressive loss in renal function, requiring initiation of chronic dialysis, which he underwent for 46 months. After kidney transplantation, the patient developed proteinuria. A renal biopsy showed recurrence of focal segmental glomerulosclerosis, and subsequently he developed renal insufficiency.