• The Korean Journal of Cytopathology
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• v.6 no.1
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• pp.48-53
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• 1995

Kimura's disease is a chronic Inflammatory disorder of unknown etiology, presenting usually as a painless subcutaneous swelling in the head and neck region or in the lymph nodes. We experienced a case of Kimura's lymphadenitis with characteristic Warthin-Finkeldey type polykaryocytes by fine needle aspiration cytology. The patient was a 10-year old male with two enlarged lymph nodes in the postauricular area. Fine needle aspiration cytology from the lymph nodes disclosed hypercellular smears with some scattered eosinophils and polykaryocytes in a polymorphous lymphoid background. There were also fragmented vessel wails and activated endothelial cell clusters in the slightly necrotic background. The Warthin-Finkeldey type polykaryocytes had three to thirty nuclei and prominent nucleoli with cytoplasmic borders. Their nuclei were arranged in grapevine or ring shaped clusters. As these polykaryocytes could also be found in lymph nodes and extranodal tissues of both reactive and neoplastic lymphoid disorders, polykaryocytes themselves are clinically nonspecific. However, the morphologic features of the Warthin-Finkeldey type giant cells are quite different from the foreign body type or Langhans' type giant cells. When the characteristic cytologic features of Kimura's disease such as significant number of eosinophils in a background of lymphoid cells asd proliferation of vessels and endothelial cells are also observed in the smear, it is possible to suggest this diagnosis in the appropriate clinical setting.

• Journal of Microbiology and Biotechnology
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• v.11 no.5
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• pp.727-738
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• 2001

Macrophagal polykaryocytes (MPs) are terminally differentiated multinuclear macrophage cells responsible for remodeling and resorption of bone, foreign body, and tissue deposition in inflammation. MPs are encountered only in bone and cartilagenous tissues, in which they are referred to as osteoclasts, odontoclasts, in which they are referred to as osteoclasts, odontoclasts, and septoclasts. Depending on the disease, the MPs differentiate into many morphological variants that include foreign-body giant cells, Langhans-type cells, and Touton-type cells. Morphological heterogeneity of MPs could Touton-type cells. Morphological heterogeneity of MPs could reflect the giant cell formation from phenotypically different marophage precursors by the process of fusion. At present, many cytokines, adhesion/fusion molecules, and other factors of the microenvironment have been discovered that influence the multinucleation process. Many evidences suggest that conditions in giant cell fibrohistiocytomas, which facilitate MP formation, are similar to the inflammation site of granulomatosis. MPs in the giant cell tumors and granulomatosis foci are formed in response to the factors secreted by mesenchymal cells. It is proposed that one of the first steps in vertebrate evolution could be the organization of skeleton remodeling, in which osteoclasts play a major role. In this step, the same mechanism of regulations served as a basis for the development of both osteoclast and inflammatory forms of MPs.

• The Korean Journal of Cytopathology
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• v.14 no.2
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• pp.86-90
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• 2003

Kimura's disease is a chronic inflammatory disorder of unknown cause and is most prevalent among Asians. The cytologic findings of Kimura's disease are significant numbers of eosinophils in a background of lymphoid cells, occasional fragments of collagenous tissue, proliferation oi vessels, and Warthin-Finkeldey polykaryocytes. Among these features, the most important cytologic feature of Kimura's disease is a significant numbers of eosinophils. We experienced a case of Kimura's disease in the parotid gland which we fatted to recognize on cytology due to the apparent paucity of eosinophils. On careful retrograde reviewing of the cytologic findings, a few scattered leukocytes, previously interpreted as polymorphous leukocytes, had bilobed nuclei and coarse green but granular cytoplasm on Papanicolaou preparation. These leukocytes showed obvious orange-red intracyloplasmic granules as in eosionophils on Giemsa stain. The paucity of eosinophils may be due to the thick fibrosis around lymphoid follicles or any technical error during aspiration. Whereas the Warthin-Finkeldey type giant cell is not a sensitive cytologic marker of Kimura's disease, it may be a helpful cytologic feature. To reach a correct cytologic diagnosis of Kimura's disease, It is important to keep in mind that searching for Warthin-Finkeldey type giant cells and evaluation of Giemsa stain for detection of eosinophils would be helpful.