A case of lung cancer-associated pulmonary embolism mimicking Kimura disease: a case report.

内容摘要

Lung cancer-associated pulmonary embolism (PE) is an acute and fatal clinical syndrome. Kimura disease is defined as a rare, chronic inflammatory disease, primarily characterized by swollen lymph nodes in the head and neck, elevated levels of eosinophils and immunoglobulin (Ig) E. PE can also occur in patients with Kimura disease due to eosinophilia. We herein reported a case of lung cancer-associated PE mimicking Kimura disease. A 36-year-old Han Chinese male was admitted complaining of repeated cough, hemoptysis, and chest pain, and his recurrent PE with pulmonary artery and bronchial artery were confirmed by chest computed tomographic angiogram (CTA) during both of his two admissions. He had enlarged lymph nodes of bilateral axilla and mediastinum and complained of skin itches, further laboratory examination showed elevated levels of eosinophils and Ig E, which mimicked the syndrome of Kimura disease. In order to clarify the diagnosis, his lymph node biopsy was suggested and performed, however, the pathologic profile of the resected lymph node referred not to Kimura disease, but lung adenocarcinoma. Then, upon definite diagnosis, the patient received standardized anticoagulant and targeted antitumor therapy, he got relief and stayed in stable condition at the time of discharge and during the subsequent 1-month follow-up. PE, swollen lymph nodes and eosinophilia may occur in both Kimura disease and solid cancer, the differential diagnosis between the two is crucial for the rational management of patients and warranted adequate attention.