J Korean Soc Radiol.  2018 Mar;78(3):157-162. 10.3348/jksr.2018.78.3.157.

Focal Hepatic Eosinophilic Infiltration in Contrast-Enhanced Ultrasonography with Sonazoid: A Case Report

• Lee DJ
• Kim DJ
• Kim G

• KMID: 2405717
• DOI: http://doi.org/10.3348/jksr.2018.78.3.157

Abstract

Focal eosinophilic infiltration in the liver is often associated with various eosinophil-related conditions. Focal eosinophilic infiltration in the liver is often identified incidentally by radiologic examinations ordered for other reasons, and is usually visualized radiographically as small, ill-defined, oval or round nodules. Focal eosinophilic infiltration in the liver may sometimes mimic hepatic metastases in those patients who present with a history of malignancy. Here, we present two cases of contrast enhanced ultrasonography findings of focal hepatic eosinophilic infiltration using Sonazoid (perfluorobutane; Daiichi-Sankyo, GE, Tokyo, Japan).

MeSH Terms

Eosinophilia
Eosinophils*
Humans
Liver
Neoplasm Metastasis
Ultrasonography*

Figure

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  Fig. 1. Focal hepatic eosinophilic infiltration in a 63-year-old male patient with lung cancer (case 1). A. Portal phase of contrast-enhanced CT scan shows an approximately 1.4 cm low-attenuated lesion on S5 of the liver (arrows). On pre-contrast CT scan and arterial phase of contrast-enhanced CT scan and 3-minute delay phase of contrast-enhanced CT scan, the lesion reveals iso-attenuation to slight low-attenuation. B. B-mode ultrasonography shows an ill-defined low echoic lesion on S5 of the liver (arrow). CT = computed tomography

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  Fig. 1. Focal hepatic eosinophilic infiltration in a 63-year-old male patient with lung cancer (case 1). C. Forty seconds after injection of Sonazoid, showing an iso-enhanced lesion. Seventy seconds after injection of Sonazoid, showing a hypo-enhanced lesion (arrows). Three minutes after injection of Sonazoid, showing a hypo-enhanced lesion (arrows). In the Kupffer phase (10 minutes after injection of Sonazoid), showing a hypo-enhanced lesion (arrows). D. Photomicrograph of biopsy specimen shows inflammatory cell infiltrations at hepatic parenchyma, predominantly composed of eosinophils (arrows) (hematoxylin and eosin stain, × 200).

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  Fig. 2. Focal hepatic eosinophlic infiltration in a 55-year-old male with an incidentally found lesion of the liver (case 2). A. Axial contrast-enhanced computed tomography scan shows an approximately 1.7 cm low-attenuation lesion on S8 of the liver (arrow). B-mode ultrasonography shows an ill-defined low echoic lesion on S8 of the liver (arrow). In the Kupffer phase (10 minutes after injection of Sonazoid), showing a hypo-enhanced lesion (arrows). B. Photomicrograph of biopsy specimen shows inflammatory cell infiltrations at hepatic parenchyma, predominantly composed of eosinophils (arrows) (hematoxylin and eosin stain, × 200).

Reference

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