Hepatic involvement in hypereosinophilia: sonographic findings.

Nam, Kyung Jin; Jung, Won-Jung; Choi, Jung Min; Koo, Bong-Sik; Park, Byeong-Ho; Lee, Ki-Nam; Han, Songhee; Shin, Woo-Won; Han, Sang Suk

doi:10.7863/jum.1999.18.7.475

Cited by 20 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most radiologic reports, however, have focused on hypereosinophilic syndrome (5-9), a clinically distinct entity from FEN affecting patients with mild eosinophilia (1) such as those described in this study. As FEN is in most cases detected incidentally and usually manifests at CT as multiple hypoattenuating lesions, differentiation from metastasis has been a problem, particularly in patients with underlying extrahepatic malignancies.…”

Section: Discussionmentioning

confidence: 99%

Focal Eosinophilic Necrosis of the Liver in Patients with Underlying Gastric or Colorectal Cancer: CT Differentiation from Metastasis

Jang

Lee

et al. 2002

Korean J Radiol

View full text Add to dashboard Cite

ObjectiveTo determine the helical CT findings which help differentiate between focal eosinophilic necrosis (FEN) of the liver and metastasis in patients with underlying gastric or colorectal cancer.Materials and MethodsIn 21 patients with underlying gastric and colorectal cancer examined during a recent 18-month period, the presence of FEN (n=90) was proven at CT. The diagnosis was verified by biopsy in eight patients and by the transient nature of the findings related to peripheral eosinophilia (>10%) in the remainder. For comparison, 20 consecutive patients with pathologically proven hepatic metastasis from gastric or colorectal cancer (n=158) were selected. Single-phase helical CT images (7-mm collimation, pitch 1:1) were independently analyzed in a random order by two blinded readers. The parameters evaluated included the margin (depicted border, fuzzy), shape (spherical, non-spherical), attenuation (subtle hypoattenuation, hypoattenuation), and the presence or absence of rim enhancement.ResultsFEN far more frequently showed a fuzzy margin (81%, 84%), subtle hypoattenuation (89%, 91%), and a non-spherical shape (84% for both readers) than metastasis, for which the respective findings were 6%, 22%; 20%, 39%; and 15%, 23%. Rim enhancement was seldom found in FEN (0%, 2%), but was recognized by both readers in 40% of metastases. For all parameters, the results were statistically significant (p < .01), and showed that both readers correctly differentiated FEN from metastasis in 78% of the patients (32/41). Interobserver agreement was, in addition, excellent (κ= 0.66).ConclusionWhen focal hepatic lesions with a fuzzy margin, non-spherical shape and subtle hypoattenuation without rim enhancement are found, the possibility of FEN should be considered even in patients with underlying gastrointestinal malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%

Focal Eosinophilic Necrosis of the Liver in Patients with Underlying Gastric or Colorectal Cancer: CT Differentiation from Metastasis

Jang

Lee

et al. 2002

Korean J Radiol

View full text Add to dashboard Cite

show abstract

“…Several reports have described the varied radiological appearance of hypereosinophilia with hepatic involvement (4-10), characterizing the hepatic lesions as small and focal. CT images demonstrated that these hepatic lesions were small, oval or round, showed low attenuation, and were scattered throughout the liver, especially in areas adjacent to the portal veins.…”

Section: Discussionmentioning

confidence: 99%

“…The number of foci was closely correlated with the percentage of eosinophils in peripheral blood, and decreased as the level of eosinophils decreased (7, 9). Ultrasound revealed that the foci were mostly hypo- (7, 10) but sometimes hyperechoic (10). …”

Section: Discussionmentioning

confidence: 99%

“…Several reports have described the sonographic, CT, and scintigraphic findings of the liver in patients with hepatic involvement (4-10), though such studies have focused only upon small, focal hepatic lesions. Over the last five years, several cases have come to light in which CT has revealed hepatic involvement over a wider area: subsegmental, segmental or lobar, for example.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Hypereosinophilic Syndrome: CT Findings in Patients with Hepatic Lobar or Segmental Involvement

Lim

Lee

et al. 2000

Korean J Radiol

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was to describe the CT findings of hepatic hypereosinophilic syndrome in which hepatic lobes or segments were involved.Materials and MethodsSeven patients with hypereosinophilic syndrome with hepatic lobar or segmental involvement were included in our study. In all seven, diagnosis was based on liver biopsy and the results of corticosteroid treatment. CT findings were retrospectively reviewed by three radiologists, who reached a consensus. Biopsy specimens were examined, with special reference to portal and periportal inflammation.ResultsCT demonstrated well-defined, homogeneous or heterogeneous low attenuation with a straight margin limited to a hepatic lobe (n = 2), segments (n = 3), or subsegments (n = 2), particularly during the portal phase. Where there was subsegmental involvement, lesions were multiple, ovoid or wedge-shaped, and showed low attenuation. In two patients with lobar or segmental involvement, segmental portal vein narrowing was observed. Histopathologic examination disclosed eosinophilic infiltration in the periportal area, sinusoids and central veins, as well as portal phlebitis.ConclusionHypereosinophilic syndrome may involve the presence of hepatic lobar, segmental, or subsegmental low-attenuated lesions, as seen on CT images. Their presence may be related to damage of the liver parenchyma and to portal phlebitis.

show abstract

“…Korean authors have addressed the possible causes of eosinophilic infiltration such as idiopathic hypereosinophilia (1, 2, 4, 6) and malignant tumors through the tumor-associated eosinophilotactic factor (3, 5, 7-9), whereas some authors have offered no explanation (3, 9). Idiopathic hypereosinophilia is a grave disease that is characterized by persistent eosinophilia of 1,500 eosinophils/µL for more than six months, and death before six months due to congestive heart failure (14).…”

mentioning

confidence: 99%