하악 이부에 생긴 Angiolymphoid hyperplasia with eosinophilia(Kimura's disease)의 치험례

THE CASE REPORT OF ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA ON CHIN

Angiolymphoid hyperplasia with eosinophilia(ALHE) is an uncommon, benign vascular proliferation with the background of a stroma which is heavily infiltrated by lymphocytes and eosinophils and includes lymphatic follicles with prominent germinal centers. ALHE primarily involves the skin and subcutis in head and neck as various forms of nodules. There has been considerable controversy about the relationship between ALHE and Kimura's disease. Kimura's disease, originally reported by Kimura et el., is an unusual granulation with proliferation of lymphoid tissue. Wells and Whimster published the first report describing a condition that resembled Kimura's disease and designated it as ALHE. For a time being two lesions are thought to be same lesion, but recently they are considered as two different entities, histopathologically. The cause of this disease remains unknown, and physicians have used a variety of treatment modalities including cryosurgery, steriod therapy, electrodesiccation, curettage, radiotherapy, laser therapy and surgical excision. But any treatment modality leaves problem of recurrence because the lesion is not well encapsulated. Being poorly encapsulated, the lesion's remnants are apt to be left and this markes some problems : recurrence and possible adjacent organ injury. In this case we misdiagnosed the lesion as well encapsulated benign mass. We performed excisional biopsy and experienced prolonged operation time and unwanted mentalis muscle injury. We think that the importance of poor encapsulation of ALHE should be stressed. So we report our experience with literature review.