Kimura's disease in a 50-year-old Tunisian man.

INTRODUCTION: Kimura's disease is an uncommon disease of unknown aetiology affecting men in their thirties from Southeast Asia. The authors report a case of Kimura's disease in a 50-year-old Tunisian man that was diagnosed after surgery. CASE REPORT: This patient had two 2-cm diameter chronic nodular lesions over the right mandible with no local inflammation and no other clinical findings of systemic disease. Histopathological examination showed germinal centre hyperplasia, eosinophilic micro-abscesses and hyperplasia of postcapillary venules, suggestive of Kimura's disease, which was confirmed by the laboratory work-up: elevated total IgE (519g/L), and eosinophilia (580/mm3). Renal function tests were normal. DISCUSSION: We concluded on a probable diagnosis of Kimura's disease in view of male gender, the head and neck site, the suggestive histological appearance, elevated IgE, and eosinophilia. However, this patient's age and ethnic origin were unusual for Kimura's disease. The main differential diagnosis is angiolymphoid hyperplasia with eosinophilia (ALHE) and renal function tests can distinguish between the two entities due to the kidney damage observed in Kimura's disease.

[Focal osteoporotic bone marrow defect of the mandible. A little documented pathology]. / Foyers d'hématopoïèse intramandibulaire. Une pathologie méconnue.

INTRODUCTION: Focal hematopoietic bone marrow defect of the mandible is a little documented benign jaw lesion. It is usually diagnosed fortuitously by orthopantomography. OBSERVATION: A 48-year-old woman was referred by her dentist for radiolucency of the molar mandibular region. This could be observed on the panoramic view as an osteoporotic lesion, located in the molar region and not well delimited. The CT scan confirmed the fact that the lesion did not affect the corticals. The biopsy confirmed the diagnosis of focal osteoporotic bone marrow defect of the mandible. DISCUSSION: These lesions have been described for more than 70 years. These benign lesions, often discovered fortuitously, mainly affect women between 40 and 60 years of age. They are mostly located in the "molar area" where tooth avulsion was previously performed, and share the same clinical and radiographic features. Nevertheless, surgical biopsy is needed to confirm the diagnosis.