Background: Although Kimura’s disease has been considered an atopic disease because of the association of peripheral blood eosinophilia and elevated serum IgE, the mechanisms of these phenomena are still unknown. Objective: It is now established that mast cells are a source of cytokines that are involved in eosinophil recruitment or IgE production. In order to understand the role of mast cells in Kimura’s disease, we conducted ultrastructural studies. Method: The 45 mast cells obtained from 2 patients with Kimura’s disease were classified into two subgroups: S type, with a predominance of scroll or crystal subelements in their granules, and P type, predominantly possessing a particulate or filamentous substructure. Results: We observed numerous P type mast cells with focal losses of granule contents in the absence of granule extrusion in Kimura’s disease. Conclusion: These results indicate the possibility that slow release of mediators or cytokines from mast cells by piecemeal degranulation may contribute to the pathomechanism of Kimura’s disease.

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