TITLE:
MR imaging of cheek lesions of Kimura’s disease: Focusing on the signal abnormalities and the relationship with superficial musculoaponeurotic systems
AUTHORS:
Ryutarou Ukisu, Yuichiro Kawahara, Norihiro Hashizume, Tamio Kushihashi, Yoshinori Yamada, Yoshiyuki Kadokura
KEYWORDS:
Kimura’s Disease; SMAS (Superficial Musculoaponeurotic Systems); MRI
JOURNAL NAME:
Modern Research in Inflammation,
Vol.2 No.4,
November
5,
2013
ABSTRACT: Background and Purpose: Kimura’s Disease (KD) is a rare
benign chronic eosinophlic inflammatory disorder, characterized by
angiolymphoid proliferation with peripheral eosinophilia and elevated serum
immunoglobulin E. Most lesions occur in the head and neck regions. To the best of our knowledge, the relationship between subcutaneous cheek lesion of KD and the surrounding
structures including superficial musculoaponeurotic systems (SMAS) has
never been reported. The purpose of this study was to describe MR imaging
findings of cheek subcutaneous lesion of KD and adjacent SMAS. Materials and Methods: Seven cheek subcutaneous lesions of 5 patients histopathologically
proved KD were evaluated. We retrospectively evaluated the MR imaging findings
of subcutaneous lesions for signal intensity in each imaging sequence, the
border of the lesions, and appearance of SMAS. Results: All cheek lesions were displacing normal fat tissue. These lesions showed ill-defined border (7/7), slightly high signal intensity on T1-weighted images (7/7), and intermediate (1/7) or high
signal intensity (6/7) on T2-weighted
images. Cheek lesions were enhanced by intravenous injection of gadolinium
to signal intensity close to that of fat tissue (3/4), and in one case, the
avid enhancement of the mass was seen (1/4). All lesions attached to the outer
surface of SMAS, however, only one out of 7 lesions distributed below the SMAS
without tearing of the
layers. SMAS below the lesion showed high
signal intensity on T2-weighted images in two lesions (2/7). Conclusion: KD should be included in the differential diagnosis when a cheek mass presents
with non-specific signal intensities and irregular border, which attaches to
but does not interrupt SMAS on MR imaging.