RESUMO
The patient is a 75 years old man complaining of ear plug and hearing loss for about three days. Physical examination shows liquid in two tympanic cavities. Chronic congestion occurs to nasal mucosa. Bilateral inferior turbinates are a little bigger than normal. Both inferior meatus are unblocked and pharyngeal recess is smooth. This patient is fat. Bilateral eye lids are swollen. A tumour could be touched in bilateral parotids with good movement and no tenderness. Its size is as big as an egg. Several lymph nodes could be touched under the jaw. The blood test is normal and IgG, IgA, IgM, ANA, anti-ENA, C3, C4, CRP and ESR is normal but RF is high. The function of liver and kidney is normal. B-mode ultrasonography result shows bilateral parotids are diffusely swollen and several swollen lymph nodes in cervix. Pathology examination of lower mandibular lymph node and parotid shows follicular lymphaticus hyperplasia with several plasmacytes and eosinophil granulocytes. The diagnosis accords with Kimura disease.