Mohd Syafiq bin Azman, Shawarinin binti Jusoh, Akmal Haliza binti Zamli and Azlina binti Abd Rahman
Purpose: To describe a case of inferior orbital mass with generalized lymphadenopathy and histopathological examination proven Kimura’s disease. Methodology: Case report Findings: A 17 year-old Malay man with no previous illness. Presented with two months history of progressive proptosis of the right eye (RE). Upon presentation vision was 6/7.5 RE and left eye (LE) 6/6. Ocular examination revealed RE proptosis with restricted extraocular muscle movement and optic disc swelling. Systemic examination noted multiple lymphadenopathy over cubital fossa and inguinal region. Blood investigation showed peripheral eosinophilia. CT brain and orbit revealed RE inferior orbital mass compressing the optic nerve. Subsequently RE orbital mass incisional biopsy and inguinal node excisional biopsy was done. The later showed typical features of Kimura’s disease with diffuse eosinophils infiltration within the germinal centres of the lymphoid nodule. He was started on tapering dose of oral corticosteroids and responded well evidenced by reducing RE proptosis. Conclusion: This case demonstrates that proptosis with lymphadenopathy does not always imply lymphoma but may have a benign pathogenesis such as Orbital Kimura’s disease. Therefore it should be considered in the differential diagnosis of orbital lesions occurring in adults. Accurate diagnosis in biopsies is also crucial to avoid unnecessary radical surgery.
