Eosionophilic pseudotumor of the liver due to Ascaris suum infection.
A case of eosinophilic pseudotumor of the liver due to Ascaris (A) suum is described in a 34-year-old-man with a high serum level of immunoglobulin E and hypereosinophilia ascribed to a history of atopic dermatitis since childhood. Multiple hepatic hypoechoic nodules detected by ultrasound were confirmed as low-density nodules on computed tomography (CT), and as low and high signal intensity lesions on T1-and T2-weighted magnetic resonance imaging (MRI), respectively. CT during arteriography (CTA) and arterial portography revealed multiple nodules with ring-shaped enhancement and perfusion defect, respectively. Biopsied liver tissue specimens did not contain tumor cells or atypical cells; instead, they showed marked infiltration of eosinophils with necrosis and Charcot-Leyden crystals in the portal tracts and hepatic sinusoides, suggesting parasitic infection, although neither larvae nor eggs were detected. The diagnosis of visceral larva migrans (VLM) due to A. suum was based on immunoserological tests. The patient was a habitual consumer of raw bovine liver, which may explain the A. suum infection. After drug therapy with albendazole, the hypoechoic nodules disappeared. Differential diagnoses and the possible transfection route of A. suum are discussed.
Department of Gastroenterology, Kobe Asahi Hospital, 3-5-25 Bouoji-cho, Nagata-ku, 653-0801, Kobe, Japan
Soo
S
Kim
Yoko
Y
Maekawa
Toshiyuki
T
Matsuoka
Susumu
S
Imoto
Kenji
K
Ando
Keiji
K
Mita
Haeng
H
Kim
Taisuke
T
Nakajima
Kwansong
K
Ku
Toshihiro
T
Koterazawa
Katsumi
K
Fukuda
Yoshihiko
Y
Yano
Miyuki
M
Nakaji
Masatoshi
M
Kudo
Ke
K
Kim
Midori
M
Hirai
Yoshitake
Y
Hayashi