A Rare Case of Kimura’s Disease Involving the Parotid Gland: CT and Diffusion MRI

Authors

  • Pasquale Frisina Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome
  • Valeria Panebianco Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome
  • Filippo Valentini Department of Sense Organs, Sapienza University of Rome, Rome
  • Alessandro Corsi Sapienza University of Rome
  • Daniela Messineo Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome

DOI:

https://doi.org/10.3941/jrcr.6153

Abstract

Kimura’s disease is a rare chronic inflammatory disorder that may involve the parotid gland and closely mimic neoplastic or
lymphoproliferative conditions on imaging. We describe the case of a 47-year-old man with parotid gland involvement, evaluated using
computed tomography and multiparametric magnetic resonance imaging, with emphasis on diffusion-weighted imaging and quantitative
apparent diffusion coefficient analysis. Computed tomography demonstrated a poorly defined soft-tissue mass within the parotid region,
associated with in traparotid and cervical lymphadenopathy and heterogeneous contrast enhancement. Magnetic resonance imaging
revealed heterogeneous signal intensity, including relatively low T2 signal, and early and progressive, relatively homogeneous enhancement
suggestive of an inflammatory process. Quantitative diffusion analysis showed intermediate apparent diffusion coefficient values, consistent
with inflammatory tissue rather than highly cellular malignant lesions. Histogram analysis showed a moderately asymmetric distribution,
supporting a heterogeneous but non-neoplastic microstructural composition. These findings differed from the typical diffusion patterns
of lymphoma and pleomorphic adenoma, with only partial overlap with ductal carcinoma. This case highlights the complementary role
of computed tomography and multiparametric magnetic resonance imaging, particularly diffusion-weighted imaging with quantitative
apparent diffusion coefficient assessment, in the noninvasive differential diagnosis of rare inflammatory diseases affecting the parotid gland.

A 47-year-old man with a painless, slowly enlarging mass in the right parotid region. Kimura’s disease. Multiparametric MRI of the neck. (a) Axial T1-weighted image demonstrates a subcutaneous periauricular lesion (blue triangle) with slightly increased signal intensity relative to adjacent muscle and poorly defined margins. An intraparotid lymph node (red circle) shows lower signal intensity relative to the surrounding parotid parenchyma (green triangle). (b) Axial T2-weighted image shows a heterogeneous signal intensity, including relatively low T2 signal, associated with intraparotid and lateral cervical lymphadenopathies (red triangles). (c) Axial dynamic contrast-enhanced fat-suppressed T1- weighted gradient-echo image (VIBE) demonstrates early and progressive enhancement of the lesion (blue triangle), without significant washout, consistent with an inflammatory pattern, and showing subtle internal signal voids suggesting vascularity. The intraparotid lymph node (red circle) shows early enhancement.. (d). Axial fat-suppressed T1-weighted spin-echo image shows relatively homogeneous enhancement of the lesion (blue triangle). The intraparotid lymph node (red circle) also demonstrates homogeneous enhancement. Technique: MRI was performed on a 1.5-T scanner using two-dimensional axial T1-weighted spin-echo sequences (slice thickness 3 mm), highresolution T2-weighted turbo spin-echo sequences, dynamic contrast-enhanced fat-suppressed T1-weighted sequences (VIBE), and fat-suppressed T1-weighted spin-echo sequences after intravenous administration of gadoteridol (ProHance®, 16 mL; injection rate 2.0 mL/s)

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Published

2026-07-30

Issue

2026: Articles in Press

Section

Dental Imaging

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