PMC6937823_01
Ultrasonography showing enlarged lymph nodes bilaterally
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Fig1
Enlargement of multiple lymph nodes was found in all areas (Fig. 1).
Ultrasonography showing enlarged lymph nodes in right parotid gland and back neck
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Fig2
Many solid nodules with a maximum size of 2.7 x 1.6 cm2 and 1.9 x 0.6 cm2 were found in the right parotid gland and right posterior neck, respectively (Fig. 2).
Histological features of excisional biopsy demonstrating eosinophilic infiltration. a Kimura Lymphadenopathy. Lymphoid follicle wth reactive germinal center (upper right), Intense eosinophilia with formation of eosinophilic microabscess(lower left). (H&E stain, x100). b Same lymph node. Diffuse eosinophilia with capillary hyperplasia. (H&E stain, x100). c Same lymph node. Eosinophilic microabscess formation with hyperplasia of endothelial cells in postcapillary venules. (H&E stain, x400)
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Fig3
Postoperative pathological findings showed KD in the right neck, left chest wall, and left axillary lymph nodes (Fig. 3).
Immunohistochemical stains of excisional retroauricular lymph node shows reactive hyperplasia expression form. (EnVision two-step stain, x40). a CD3 is expressed by numerous T cells located in interfollicular zone, fewer T cells in follicular germinal center, mostly of Th cells, b CD20 is expressed by abudantly hyperplastic reactive Lymphoid follicles, c CD21 highlights nodular FDC network. d BCL-2 stainning shows the germinal center of hyperplastic follices negative, but mantle zone of follicles and interfollicular zone positive, e Ki-67 stainning indicates the proliferation index of lymphocytes in germinal center of secondary follicular germinal centers high expression
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Fig4
T lymphoid tissue suggested CD2, CD3, CD5, CD7, CD4, and CD8 positivity; BCL-6, CD10, and PD-1 negativity; no identified Reed-Sternberg (RS)-like cells (CD15 and CD30 negative) and proliferation of follicular dendritic cells (FDCs); and a nodular FDC network for CD21 (Fig. 4). The final diagnosis for this patient was KD.