You Sung Kim, Presenter: Nothing to Disclose

Jae Young Byun MD, PhD, Abstract Co-Author: Nothing to Disclose

Sung Eun Rha MD, Abstract Co-Author: Nothing to Disclose

Seung Eun Jung MD, Abstract Co-Author: Nothing to Disclose

Soon Nam Oh, Abstract Co-Author: Nothing to Disclose

Yu Ri Shin MD, Abstract Co-Author: Nothing to Disclose

Young Joon Lee MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to describe unusual US and CT findings of focal eosinophilic infiltration(FEI) in the liver.

We retrospectively reviewed US and CT images of 71 nodules in 47 patients with FEI in the liver. Of 47 patients, 28 underwent both US and CT, and 19 only CT scans. FEI of the liver was diagnosed by pathologically proven foci of eosinophilic infiltration(n=17) or suggestive clinical findings seen in combination with transient nature of lesions as they disappeared or partially regressed on follow-up imaging studies(n=30).

Typical findings of eosinophilic infiltration are multiple, small, ill-defined hypoattenuating nodules which are most conspicuous on portal phase on CT, and small, ill-defined, hypoechoic nodules on US. Of 41 nodules, detected in 28 patients who had both US and CT, 22 showed typical US findings of eosinophilic infiltration, and 15 were not detected on US. Unusual US findings were peripheral hyperechoic rims(n=3) and slightly hyperechoic lesions(n=1). Of the entire 71 nodules seen on CT, 64 demonstrated typical CT findings. Unusual CT findings were perilesional arterial enhancement(n=2), ill-defined hypoattenuating nodules on delayed phase with non-visualization on portal phase(n=2), discrete hypoattenuating nodules on portal phase(n=1), tubular shaped hypoattenuating nodules(n=1), and ill-defined enhancing nodules on delayed phase(n=1).

FEI in the liver with unusual imaging findings could mimic metastasis, hepatocellular carcinoma, or hemangioma. Unusual imaging findings of FEI should be recognized, and eosinophilic infiltration should be included in the differential diagnosis of unusual manifestations of focal hepatic lesions, especially in patients with peripheral eosinophilia.

Knowing the unusual imaging findings of FEI in the liver is important to avoid unnecessary invasive treatments and procedures.

Kim, Y, Byun, J, Rha, S, Jung, S, Oh, S, Shin, Y, Lee, Y, et al, 0, Unusual Imaging Findings of Focal Eosinophilic Infiltration in the Liver on US and CT.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007749.html