Objective To further investigate the diagnostic pitfalls of Kimura's disease(KD).Methods We report one case of Kimura's disease accompanied with mediastinal lymphadenopathy admitted to General Hospital of Chinese PLA in the year 2010.After searching on PubMed and Chinese Medical Journal Searching Engines(Wanfang data base,Cqvip data base),we have found literatures reporting another 3 cases of Kimura's disease with mediastinal lymphadenopathy.Plus the one we presented,all four patients' clinical data were collected and analyzed thereafter.Up-to-date advancement on KD's diagnosis and therapy would also be reviewed.Results Our case,a 61-year-old male,was initially misdiagnosed as lung cancer with mediastinal metastasis in 2008,but histopathology had confirmed only eosinophil infiltration in enlarged mediasinal lymph nodes,no malignant cells were identified.In the year 2010,he complained bilateral orbital masses,one of which was surgically removed,and was later confirmed as Kimura's disease by histopathology.Clinical features of 4 patients,including our case and the other 3 retrieved in literatures,were available,2 of whom were misdiagnosed as lung cancer while the other 2 as lymphoma in the beginning.All the 4 patients were responsive to steroid therapy.Conclusions Kimura's disease could be associated with mediastinal lymphadenopathy which may confuse the physicians in diagnosing.Newly developed minimal invasive approaches such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are helpful for the differential diagnosis.%目的 探讨木村病的诊断误区.方法 报道解放军总医院2010年收治的伴纵隔淋巴结肿大的木村病1例.在PubMed以及万方、维普等数据库搜索相关文献,查及木村病伴纵隔淋巴结肿大的病例3例.分析包括本例在内的4例患者的临床资料,总结近年来关于木村病的诊断及治疗方面的最新进展.结果 本例患者为61岁男性,最初于2008年诊断为肺癌,但组织病理学检查未见癌细胞,纵隔淋巴结内仅见嗜酸性粒细胞浸润.2010年患者因双侧眼眶肿物就诊,手术病理证实为嗜酸性粒细胞肉芽肿,即木村病.复习文献并加上本例在内,共获得4例合并纵隔淋巴结肿大的木村病患者的临床资料.其中2例误诊为肺癌,2例误诊为淋巴瘤.激素治疗对全部4例患者均有效.结论 木村病伴纵隔淋巴结肿大病例极其罕见,临床上易误诊.微创纵隔穿刺活检技术,如超声内镜和超声内镜引导下的经支气管针吸活检对鉴别诊断有帮助.
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