Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Penyakit Kimura Parotis (Parotid Kimura Disease)

Penyakit kimura adalah kelainan inflamasi kronis, ditandai adanya limfadenopati atau massa jaringan lunak subkutan, tanpa nyeri, sering mengenai daerah kepala dan leher. Pertama kali dilaporkan di Cina path 1937, disebut limfogranuloma hiperplastik eosinofihik. Tahun 1948, ditemukan keterlibatan komponen vaskular oleh Kimura, sehingga disebut Penyakit Kimura. Rasio perbandingan laki-laki dibandingkan wanita adalah 3.5-9 1. Insidensi usia adalah 20-30 tahun. Kasus remaja laki-laki berusia 17 tahun datang ke Poliklinik THT-KL RSHS Bandung dengan keluhan benjolan leher sebelah kin, daerah parotis, kelenjar getah bening level Lb dan IL Keluhan dirasakan sejak 2 bulan sebelumnya. Awalnya benjolan berukuran diameter 5 mm, membesar sampai sebesar 90 mm, mudah bergerak dan tidak nyeri path perabaan. Metode pemeriksaan laboratonium darah menunjukkan nilai eosinofil 22%, protein 9.4 gr/dL, dan serum IgE 3,8 mg/dL. Ultrasonografi leher menunjukkan masse solid yang dominan dengan bagian kistik di dalamnya yang mengobliterasi sebagian kelenjar parotis kin. Pemeniksaan biospi jarum halus menunjukkan karsinoma parotis kemungkinan suatu mukoepidermoid. CT-Scan menunjukkan gambaran masse solid di daerah pre-parotis kiri dan lesi hipodens multipel bulat di daerah pre-parotis dan pre-aunikula kin. Hasil pemeniksaan histopatologis pasca operasi menunjukkan gambaran penyakit kimura parotis. Diskusi pasca operasi, dibenikan radioterapi dengan dosis 30 Gy, dilakukan kontrol selama sate tahun, tanpa terapi tärmakologis, tidak ditemukan angka kekambuhan penyakit.

Kimura Disease is a rare chronic infiamation characterized by painless lympahadenopathy or subcutaneous soft tissue mass ocasionally affected head and neck region. First reported in China at 1937, termed “Hyperplastic Eosinophilic Lymphogranuloma “. At 1948, microscopic study by Kimura showed that vascular component involvement, then named as Kimura Disease. Males are more prevalent then females with incidence the of 3.5-9: 1 and at age of20th – 30th. Case ayoung male outpatient aged 17th came to ORL-HNS Clinic Hasan Sadikin Hospital Bandung with chief complaint ofpainless swelling at left neck region, located at parotid region, neck lymph node level lb don II. The patient has been having this complaint for about 2 months. The nodule size that was initially 5 mm diameter; is now getting bigger and has reached 90 mm in diameter; the nodule is mobile and painless. Methods blood laboratory showed that eosinofil: 22%, protein: 9.4 gr/dL, and serum IgE value: 3.8 mg/dL. Neck ultrasonography showedthatasolid dominant mass with a cyst inside, obliteratedthe left parotid gland Fine needle aspiration biopsy revealed that parotid carcinoma suspected mucoepidermoid CT-Scan result revealed a solid mass at left pre-pamtid and multiple hipodense lesion at left pre-parotid and pre-auricle. The result post-operative histopathologic examination result showed a kimura disease appearance. Discussion radiotherapy 30 Gy has been given after the surgery. Follow-up in 1 year period, without pharmacologic therapy, showed that no relapsing mass.