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

Dong Jun Lee; Dae Jung Kim; Gwangil Kim

doi:10.3348/jksr.2018.78.3.157

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Lee, Kim, and Kim: Focal Hepatic Eosinophilic Infiltration in Contrast-Enhanced Ultrasonography with Sonazoid: A Case Report

Case Report

J Korean Soc Radiol 2018;78(3):157-162.

Published online: 20 January 2018

DOI: https://doi.org/10.3348/jksr.2018.78.3.157

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

Dong Jun Lee, MD¹, Dae Jung Kim, MD^1,^∗, Gwangil Kim, MD²

¹Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

²Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

^∗Corresponding author: Dae Jung Kim, MD Department of Radiology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel. 82-31-780-5425 Fax. 82-31-780-5381 E-mail: choikim75@gmail.com

Received 14 July 2017 Revised 8 September 2017 Accepted 18 September 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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).

Keywords: Index terms Sonazoid Ultrasonography Liver Eosinophilia

References

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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

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).

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).

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