Kimura disease: A rare case affecting the inguinal lymph node

A 70-year-old Chinese woman with underlying hypertension and ischemic heart disease (on clopidogrel 75 mg daily) presented with a painless lump over the right inguinal region, which had appeared three months prior. The swelling was intermittent without discharge, fever, weight loss, or systemic symptoms. She had no history of malignancy, tuberculosis, recent infections, or trauma. Examination revealed a 2 × 2 cm, firm, mobile, non-tender swelling over the right inguinal region. No other lymph nodes were palpable. A two-week course of empirical antibiotics (amoxicillin-clavulanate 625 mg TID) resulted in temporary resolution, but the swelling recurred a month later. Ultrasound revealed an enlarged lymph node with preserved architecture, while CT abdomen and pelvis showed non-necrotic lymphadenopathy without hepatosplenomegaly. Serum IgE was elevated at 1200 IU/mL. No other lymphadenopathy was detected in the neck, axilla, or other catchment areas. Fine-needle aspiration cytology (FNAC) was inconclusive, leading to surgical excision of three lymph nodes. Histopathological examination confirmed Kimura disease, showing follicular hyperplasia with eosinophilic infiltration and vascular proliferation. Postoperatively, she received oral prednisolone (30 mg daily for 4 weeks, tapered over 3 months). At the 18-month follow-up, she remained asymptomatic without recurrence.