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Eosinophilic Liver Infiltration.

Santiago Rivera L, Figueroa Rivera I, Toro DH, Gutierrez J, Acosta E - ACG Case Rep J (2015)

Bottom Line: Eosinophilic liver infiltration is a commonly encountered focal eosinophil-related inflammation with or without necrosis, which can be seen on computed tomography (CT) in the presence of peripheral eosinophilia.Although this entity has a relatively benign course, it is related to numerable conditions for which diagnosis may be challenging and requires substantial diagnostic work-up for proper management and care of the underlying disease.We report a case of a 60-year-old man who presented with a 1-week history of right upper quadrant abdominal pain with multiple ill-defined liver hypodensities associated with significant eosinophilia.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, VA Caribbean Healthcare System, San Juan, Puerto Rico.

ABSTRACT
Eosinophilic liver infiltration is a commonly encountered focal eosinophil-related inflammation with or without necrosis, which can be seen on computed tomography (CT) in the presence of peripheral eosinophilia. Although this entity has a relatively benign course, it is related to numerable conditions for which diagnosis may be challenging and requires substantial diagnostic work-up for proper management and care of the underlying disease. We report a case of a 60-year-old man who presented with a 1-week history of right upper quadrant abdominal pain with multiple ill-defined liver hypodensities associated with significant eosinophilia.

No MeSH data available.


Related in: MedlinePlus

H&E stain of liver biopsy showing mild mononuclear inflammation with scattered eosinophils infiltrating the periportal and lobular area at (A) 10x magnification and (B) 40x magnification.
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Figure 2: H&E stain of liver biopsy showing mild mononuclear inflammation with scattered eosinophils infiltrating the periportal and lobular area at (A) 10x magnification and (B) 40x magnification.

Mentions: The patient was admitted with suspected hypereosinophilic syndrome. Tests for ova, parasites, Schistosoma, Strongyloides, Toxocara canis, Fasciola, and acid fast bacilli were negative. An upper endoscopy and colonoscopy were normal except for mild diverticulosis. Liver biopsy demonstrated mild chronic inflammation with eosinophilic infiltration (Figure 2). Testing for chronic eosinophilic leukemia (CEL), a rare but possible cause of eosinophilia, was also negative. Given the patient's report of past exposure to schistosomiasis, praziquantel was started empirically, pending serology test. Helicobacter pylori titers were positive, and treatment was provided accordingly. The symptoms slowly improved despite persistent eosinophilia, and the patient was discharged with close follow-up.


Eosinophilic Liver Infiltration.

Santiago Rivera L, Figueroa Rivera I, Toro DH, Gutierrez J, Acosta E - ACG Case Rep J (2015)

H&E stain of liver biopsy showing mild mononuclear inflammation with scattered eosinophils infiltrating the periportal and lobular area at (A) 10x magnification and (B) 40x magnification.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612763&req=5

Figure 2: H&E stain of liver biopsy showing mild mononuclear inflammation with scattered eosinophils infiltrating the periportal and lobular area at (A) 10x magnification and (B) 40x magnification.
Mentions: The patient was admitted with suspected hypereosinophilic syndrome. Tests for ova, parasites, Schistosoma, Strongyloides, Toxocara canis, Fasciola, and acid fast bacilli were negative. An upper endoscopy and colonoscopy were normal except for mild diverticulosis. Liver biopsy demonstrated mild chronic inflammation with eosinophilic infiltration (Figure 2). Testing for chronic eosinophilic leukemia (CEL), a rare but possible cause of eosinophilia, was also negative. Given the patient's report of past exposure to schistosomiasis, praziquantel was started empirically, pending serology test. Helicobacter pylori titers were positive, and treatment was provided accordingly. The symptoms slowly improved despite persistent eosinophilia, and the patient was discharged with close follow-up.

Bottom Line: Eosinophilic liver infiltration is a commonly encountered focal eosinophil-related inflammation with or without necrosis, which can be seen on computed tomography (CT) in the presence of peripheral eosinophilia.Although this entity has a relatively benign course, it is related to numerable conditions for which diagnosis may be challenging and requires substantial diagnostic work-up for proper management and care of the underlying disease.We report a case of a 60-year-old man who presented with a 1-week history of right upper quadrant abdominal pain with multiple ill-defined liver hypodensities associated with significant eosinophilia.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, VA Caribbean Healthcare System, San Juan, Puerto Rico.

ABSTRACT
Eosinophilic liver infiltration is a commonly encountered focal eosinophil-related inflammation with or without necrosis, which can be seen on computed tomography (CT) in the presence of peripheral eosinophilia. Although this entity has a relatively benign course, it is related to numerable conditions for which diagnosis may be challenging and requires substantial diagnostic work-up for proper management and care of the underlying disease. We report a case of a 60-year-old man who presented with a 1-week history of right upper quadrant abdominal pain with multiple ill-defined liver hypodensities associated with significant eosinophilia.

No MeSH data available.


Related in: MedlinePlus