Hypereosinophilic syndrome: CT findings in patients with hepatic lobar or segmental involvement.
OBJECTIVE
The purpose of this study was to describe the CT findings of hepatic hypereosinophilic syndrome in which hepatic lobes or segments were involved.


METHODS
Seven 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.


RESULTS
CT 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.


CONCLUSIONS
Hypereosinophilic 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.
Lim
J H
JH
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhlim@smc.samsung.co.kr
Lee
W J
WJ
Lee
D H
DH
Nam
K J
KJ
D000328:Adult; D005260:Female; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D014057:Tomography, X-Ray Computed