F-18 FDG Uptake in an Eosinophilic Liver Abscess Mimicking Hepatic Metastasis on PET/CT Images / 핵의학분자영상

A 61-year-old man had a F-18 FDG PET/CT scan for evaluation of a common bile duct cancer identified on CT. The PET/CT image showed a hypermetabolic mass in the common bile duct, and a focal area of increased F-18 FDG uptake in segment IV of the liver, which corresponded to a hypoattenuated lesion on non-enhanced CT, and was consistent with hepatic metastasis. The patient underwent choledochojejunostomy with hepatic resection, and pathologic findings were compatible with an eosinophilic abscess in the liver. This case demonstrates that F-18 FDG uptake by an eosinophilic abscess can mimic hepatic metastasis in a patient with a malignancy.

Eosinophilic Liver Abscess / 대한간학회지

No abstract available.

A Case of Gastric Submucosal Tumor Suspected to be Caused by Anisakis / 대한소화기내시경학회지

Anisakiasis is a parasitic disease following eating raw fishes infected with Anisakis larvae. The endoscopic features of the gastric mucosa are edema, erosion, ulceration and hemorrhage. Gastric anisakiasis forming submucosal tumor is rare. Twenty six-year-old man who complained of severe epigastric pain was admitted. The pain began approximately three hours after eating slices of raw Astroconger myriaster. Gastric endoscopy revealed a submucosal tumor with central erosion on the gastric fundus. Endoscopic ultrasonography detected a thickening of the gastric wall made of mainly thickened submucosal layer. Abdominal CT scan showed a gastric mass lesion with hypodensity in the gastric fundus and subsequently wedge resection was performed. The pathologic finding of the resected mass was eosinophilic abscess in the submucosal layer. We report a case of gastric submucosal tumor which seems to be caused by Anisakis, with a review of relevant literature.

The characteristics of the five cases of hepatic eosinophilic abscess / 대한내과학회지

Hepatic eosinophilic abscess is a very rare disease which has been reported in fascioliasis, and some gastrointestinal malignancy. We experienced 5 cases with hepatic eosinophilic abscesses which were caused by unknown etiology, confirmed by liver biopsy, from 1990 to 1994. The chracteristics of the cases including clinical menifestations, serologic findings, ultrasonography and abdominal computerizes tomogram(CT) were summerized. They had no characteristic findings except eosinophilia in clinical menifestations and they showed various ultrasonographic and CT findings which are different from the radiologic findings of liver abscesses by bacterial or amebic infection. We think that hepatic eosinophilic abscess must be included in differential diagnosis of all hepatic tumors.

Overestimation of the Depth of Invasion in Early Gastric Cancer due to Eosinophilic Abscess by Endoscopic Ultrasonography / 대한소화기내시경학회지

Eosinophilic abscess is a rare disease of stomach that consists of many eosinophils in submucosa and muscle layers of stomach. Eosinophilic abscess is usually observed in liver after parasite infestation such as hepatic fascioliasis or in intradermal lesion of pemphigus. A 67-year-old female was admitted due to epigastric pain and indigestion. Endoscopic finding suggested early gastric cancer type IIc with the depth of invasion to mucosal layer at the lesser curvature of lower body. Histologic examination of endoscopic biopsy proved to be signet ring cell type adenocarcinoma. On endoscopic ultrasonography, the tumor was imaged as a slightly elevated mass with 15 mm in diameter. The lesion was localized from the first layer to the fourth layer which correspond to the mucosa and the proper muscle layer, The lesion consisted of low echoic and isoechoic densities. The lower echoic lesion ranging from the third layer to the fourth layer was thought to be necrotic or hemorrhagic portion within the tumor. Subtotal gasterectomy was performed. We compared the endoscopic and endosonographic features with the histologic findings of the resected stomach. Histologic examination showed signet ring cell carcinoma in mucosal layer and eosinophilic abscess in submucosal and proper muscle layer. We concluded that the endosonographic depth of invasion was overestimated because of the eosinophilic abscess.