Granulomatous arteritis with massive eosinophilic leukocyte infiltration and transient peripheral eosinophilia subsequent to transarterial embolization therapy with a gelatin sponge.
A 38-year-old man presented with a cavernous hemangioma in the liver. Transarterial embolization (TAE) using a gelatin sponge was carried out 14 days prior to surgical resection of the tumor. Granulomatous arteritis with massive infiltration by eosinophilic leukocytes and histiocytes was present at the periphery of the hemangioma, and transient eosinophilia in the peripheral blood occurred six days after resection. Granulomatous arteritis was evident in medium-sized arteries and there was narrowing or occlusion of the vascular lumen. In the granulomatous cellular infiltrates in the arteries, giant cells of the foreign body type were numerous. An eosinophilic substance differing from fibrin was present in some of the vascular lumina. As this showed staining for collagen, it was considered likely to be fragments of the gelatin sponge. The patient had no symptoms of fever, chills or general fatigue. The clinical course and pathologic findings suggest a causative role of the gelatin sponge in this case of granulomatous arteritis. Vascular change, a rare complication of TAE therapy, may be induced by a hypersensitivity reaction against the intra-arterial gelatin sponge.
Ishikura
H
H
Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan.
Sotozaki
Y
Y
Adachi
H
H
Sato
M
M
Yoshiki
T
T
D000328:Adult; D001167:Arteritis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D002465:Cell Movement / Q000502:physiology; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004802:Eosinophilia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects* / Q000627:therapeutic use; D006391:Hemangioma / Q000473:pathology / Q000628:therapy; D006801:Humans; D006967:Hypersensitivity / Q000473:pathology; D007150:Immunohistochemistry; D007962:Leukocytes / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy; D008297:Male