J Korean Radiol Soc.  1993 Aug;29(4):757-764.

Hypereosinophilic syndrome: Clinical, laboratory, and imaging manifestations in patients with hepatic involvement

• Kim GB
• Kim OH
• Lee JM
• Sung YS
• Kang DS

Abstract

The hyperosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitologic, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US) of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosnophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benign eosinophilic infiltrates and one of them revealed combined centrilobular necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least one of CT, US, or scintigraphy. These findings completely disappeared in 2 To 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphy. These findings completelydisappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnoses of these findings should include metastatic disease, lymphoma, leukemia. candidiasis or other opportunistic infections.

MeSH Terms

Abdomen
Biopsy
Bone Marrow
Candidiasis
Cough
Diagnosis, Differential
Eosinophilia
Eosinophils
Fever
Hepatocytes
Hepatomegaly
Histamine Antagonists
Humans
Hypereosinophilic Syndrome*
Hyperplasia
Leukemia
Leukocytosis
Liver
Lymphoma
Necrosis
Opportunistic Infections
Radionuclide Imaging
Spleen
Ultrasonography
Histamine Antagonists