Clinical features:
(1) Most cases are from the Far East (China, Japan, Singapore).
(2) There is a male predominance.
(3) Most patients are young to middle aged adults.
(4) Most patients may be manual laborers or have a lower social status.
Clinical involvement - some or all of the following:
(1) painless enlargement of salivary glands, often with bilateral enlargement of the parotid glands
(2) painless enlargement of cervical lymph nodes
(3) subcutaneous nodules, which may be on the trunk or extremities
(4) occasionally lesions may be found in the axilla, groin, popliteal fossa or distal extremity
Histologic features:
(1) lymphoid hyperplasia, with lymphoid follicles containing florid germinal centers
(2) marked eosinophilic infiltrate
(3) occasional foreign body giant cells
(4) increased vascularity with thin-walled capillaries
(5) patchy fibrosis
Laboratory findings:
(1) peripheral blood eosinophilia
(2) increased serum IgA
Imaging studies:
(1) The lesions are enhanced on CT scan with contrast due to the increased vascularity of the lesion.
Diagnosis requires exclusion of other causes for eosinophilia and lymphoid hyperplasia, especially parasitic disease.
