Head and neck lesions of Kimura's disease: exclusion of human herpesvirus-8 and Epstein-Barr virus by in situ hybridisation and polymerase chain reaction. An immunohistochemical study

J Craniomaxillofac Surg. 2010 Jun;38(4):266-70. doi: 10.1016/j.jcms.2009.08.001. Epub 2009 Sep 12.


Introduction: Kimura's disease (KD) is a chronic inflammatory disorder, characterised by tumour-like lesions in the head and neck region, producing salivary gland nodules and lymph node enlargement. Many authors suggest that KD is a reactive immunological disorder; however, its aetiology remains unknown.

Aims: To study immunohistochemical characteristics of head and neck lesions of KD (H&N-KD) and to investigate the possible role of human herpesvirus-8 (HHV-8) and Epstein-Barr virus (EBV) in the development of H&N-KD.

Patients and methods: This study enrolled five H&N-KD specimens from three patients treated between 1995 and 2005 at Pitié-Salpêtrière University Hospital, Paris, France. Immunohistochemical studies were performed on formalin-fixed, paraffin-embedded tissue. HHV-8 DNA was determined by polymerase chain reaction (PCR) analysis, whilst EBV sequences were identified by PCR and in situ hybridisation.

Results: The immunohistochemical studies revealed CD20+ germinal centres with prominent staining of CD23+ dendritic reticular cells, surrounded by numerous interfollicular CD3+, and CD4+ or CD8+ T-cells. Factor VIII-related antigen, CD31 and CD34 occurred in the thin-walled blood vessels. The reactivity of CD1a, HHV-8 and EBV-associated latent membrane protein 1-EBV (LMP1-EBV) were negative, and in situ hybridisation confirmed the lack of EBV DNA. No patient recalled an external insult or chronic irritation.

Conclusions: The results of this study indicate the reactive nature of H&N-KD (or a subset of H&N-KD), and it is unlikely that HHV-8 and EBV play a role in the pathogenesis of the lesion. However, the patients in this series did not have previous history of trauma or chronic irritation; thus, a neoplastic origin could not be excluded. Further multicentre studies based on more specimens are warranted.

MeSH terms

  • Adult
  • Angiolymphoid Hyperplasia with Eosinophilia / immunology
  • Angiolymphoid Hyperplasia with Eosinophilia / pathology
  • Angiolymphoid Hyperplasia with Eosinophilia / virology*
  • Antigens, CD / immunology
  • Head / pathology
  • Herpesviridae Infections / immunology
  • Herpesviridae Infections / virology*
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / isolation & purification*
  • Herpesvirus 8, Human / immunology
  • Herpesvirus 8, Human / isolation & purification*
  • Humans
  • Immunohistochemistry
  • Male
  • Neck / pathology
  • Retrospective Studies


  • Antigens, CD