Kimura disease is a rare entity causing subcutaneous swellings and lymphadenopathy, with hardly 120 cases reported worldwide. It is mainly seen in Asian men. Herein, we present a typical case that presents with submandibular mass and persistent eosinophilia. The patient was a 38-year-old man suffering from left submandibular mass for the last 5 years. It has happened upon a dental infection. Treatment with prednisolone resulted temporary decrease in the size of the lesion, but it wouldn't disappear totally. Since the swelling did not get improved, an excisional biopsy was conducted. The high rate of the eosinophil and histopathology results conducted us to diagnose him with Kimura.
Histologically, Kimura disease presents as lymphadenopathy with preserved lymph node architecture and reactive and prominent germinal centers. Dense eosinophilic infiltration of the interfollicular zones, lysis of the follicles, and occasionally microabscesses are seen. Granuloma formations contain infiltration of eosinophils, lymphocytes, plasma cells, and histiocytes. Tissue fibrosis, sclerosis, and vascular proliferation are also present. Vessels remain thin-walled with cubical endothelial cells. This was in line with our patient symptoms.