No abstract available.
Adult ; Breast Neoplasms/diagnosis ; Carcinoma, Hepatocellular/diagnosis ; Eosinophilia/*diagnosis/radiography ; Eosinophils/immunology/metabolism ; Female ; Humans ; Liver Abscess/*radiography/ultrasonography ; Liver Neoplasms/diagnosis ; Male ; Middle Aged

Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.
Adult ; Diagnosis, Differential ; Eosinophilia/*diagnosis/radiography/surgery ; Female ; Humans ; *Magnetic Resonance Imaging ; Otitis Media/*diagnosis/radiography/surgery ; Otoscopy ; Reoperation ; *Tomography, X-Ray Computed

In 1932, Loffler described a syndrome of self-limiting, transient pulmonary infiltrates associated with peripheral blood eosinophilia and mild pulmonary symptoms. A number of conditions are related to pulmonary eosinophilia or pulmonary infiltration with eosinophilia. Especially, parasitic infestations are often related to pulmonary eosinophilia, but only two cases associated with Clonorchis sinensis have been anecdotally reported in English literature. Here we report a case of migrating pulmonary eosniophilic infiltrations associated with Clonorchis sinensis that was successfully treated with praziquantel. Clonorchiasis should be considered in patients with marked eosinophilia and pulmonary infiltrations.
Animals ; Biopsy ; Clonorchiasis/*complications/*diagnosis ; Clonorchis sinensis/*isolation & purification ; Human ; Male ; Middle Aged ; Pulmonary Eosinophilia/*etiology/pathology/radiography ; Syndrome

No abstract available.
*Diagnostic Errors ; Eosinophilia/*diagnosis/pathology/radiography ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Abscess/*diagnosis/pathology/radiography ; Liver Neoplasms/diagnosis/secondary ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

Exogenous lipoid pneumonia is an uncommon medical condition resulting from aspiration or inhalation of oily material. Generally, lipoid pneumonia has nonspecific clinical and radiological presentations, and may be misdiagnosed as bacterial pneumonia or lung cancer. We describe an unusual case of exogenous lipoid pneumonia accompanied by peripheral blood and pulmonary eosinophilia. A 63-year-old man was admitted with progressively worsening exertional dyspnea and productive cough for 5 days. A chest radiograph showed abnormalities in the lower lobe of the right lung, and a diagnosis of community-acquired pneumonia was made; intravenous antibiotics were administered. However, dyspnea and hypoxia gradually worsened and peripheral blood eosinophilia developed. A bronchoscopy was performed and bronchoalveolar lavage fluid analysis showed markedly increased numbers of eosinophils (40%). Subsequently, a comprehensive review of history revealed that he fell asleep with camellia oil in his mouth for 2 weeks to relieve foreign body sensation of the throat. Sputum and bronchoalveolar lavage fluid cytology showed the presence of lipid-laden macrophages. He was diagnosed with lipoid pneumonia and acute eosinophilic pneumonia. Chest radiograph and symptom were rapidly improved after treatment with intravenous methylprednisolone.
Anoxia ; Anti-Bacterial Agents ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Camellia ; Cough ; Diagnosis ; Dyspnea ; Eosinophilia ; Eosinophils* ; Foreign Bodies ; Humans ; Inhalation ; Lung ; Lung Neoplasms ; Macrophages ; Methylprednisolone ; Middle Aged ; Mouth ; Pharynx ; Pneumonia* ; Pneumonia, Bacterial ; Pneumonia, Lipid ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Respiratory Aspiration ; Sensation ; Sputum

Anti-IgE therapy, using recombinant humanized anti-IgE antibodies, is clinically effective in patients with eosinophil-related disorders such as allergic asthma, allergic rhinitis, and chronic urticaria. Chronic eosinophilic pneumonia tends to respond promptly to systemic corticosteroid therapy, however; relapses are common following corticosteroid tapering. We treated two patients (17- and 19-yr-old males) of chronic eosinophilic pneumonia whose symptoms were cough and dyspnea on exertion. The symptoms were recurrent while tapering off corticosteroid. They were treated with anti-IgE antibody without recurrence for 2 yr and 15 months. Here, we first describe clinical experience of the 2 cases of chronic eosinophilic pneumonia.
Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Antibodies, Anti-Idiotypic/*therapeutic use ; Cough/etiology ; Dyspnea/etiology ; Humans ; Male ; Pulmonary Eosinophilia/diagnosis/radiography/*therapy ; Tomography, X-Ray Computed ; Young Adult

Eosinophilic enteritis is an uncommon disease that rarely manifests as an acute abdomen. A 50-year-old man visited our hospital and complained of epigastric and periumbilical pain. He reported direct and rebound tenderness over the periumbilical area. Laboratory examinations showed leukocytosis without eosinophilia. Plain abdominal radiography revealed air-fluid levels in the small intestine and computed tomography revealed concentric wall thickening in the small bowel and ascites in the pelvic cavity. We conducted an emergency operation and segmental resection of the jejunum was performed. Histologically, transmural, eosinophilic infiltration was observed. In patients with intestinal obstruction, even when presenting with an acute abdomen with no peripheral eosinophilia, eosinophilic enteritis should be included in the differential diagnosis.
Abdomen, Acute ; Ascites ; Diagnosis, Differential ; Emergencies ; Enteritis ; Eosinophilia ; Eosinophils ; Gastritis ; Gastroenteritis ; Humans ; Intestinal Obstruction ; Intestine, Small ; Jejunum ; Leukocytosis ; Middle Aged ; Radiography, Abdominal

PURPOSE: To evaluate the radiographic findings of gastrointestinal anisakiasis with clinical and pathologic correlation. MATERIALS AND METHODS: In ten patients, findings were retrospectively analysed. There were two cases of the gastric variety of gastrointestinal anisakiasis and eight of the intestinal, and they were diagnosed during gastroscopy, by resection during surgery, and on the basis of typical clinical findings. All ten patients underwent both plain radiography and CT scanning of the abdomen. US was performed in five patients and an upper gastrointestinal series in one. Clinical data were evaluated with regard to a history of raw fish ingestion, time from ingestion of raw fish to onset of symptoms, location of abdominal pain, and laboratory data. Radiologic findings were analysed in terms of wall thickening and appearance, mesenteric infiltration, bowel dilatation proximal to lesion, and ascites. RESULTS: All patients had a history of recent ingestion of raw fish and complained of severe abdominal pain that occurred approximately 7-48 hours later. Pain occurred in the lower abdomen in five patients, the epigastrium in four, and the right lower abdomen in two. Laboratory test disclosed the leukocytosis in eight patients and eosinophilia in three. In all cases of intestinal anisakiasis, ileus was demonstrated on plain radiographs of the abdomen, while the upper gastrointestinal series showed mucosal thickening and multiple filling defects. US findings were bowel thickening and dilation, and on CT images, wall thickening revealed a target sign. Mesenteric infiltration and ascites were seen in seven patients. In four who underwent surgery, a cross-section through the lesion revealed submucosal eosinophilic granuloma with Anisakis larva. CONCLUSION: Although the CT findings are non-specific, taken in conjunction with characteristic clinical findings, they may be helpful in the diagnosis of gastrointestinal anisakiasis.
Abdomen ; Abdominal Pain ; Anisakiasis* ; Anisakis ; Ascites ; Diagnosis ; Dilatation ; Eating ; Eosinophilia ; Eosinophilic Granuloma ; Gastroscopy ; Humans ; Ileus ; Larva ; Leukocytosis ; Parasites ; Radiography ; Retrospective Studies ; Tomography, X-Ray Computed

Chronic eosinophilic pneumonia is characterized by multiple and dense areas of consolidation on chest radiographs and computed tomographic scans, persistent symptoms, a requirement for steroid therapy and possible relapses. The finding of increased BAL eosinophils is most helpful in diagnosis of patients presenting with chronic eosinophilic pneumonia. Therefore, although biopsy remains the gold standard for diagnosis of chronic eosinophilic pneumonia, it is usually not required if the clinical findings are characteristic and if the response to a trial of corticosteroids is rapid and complete. The male patient, aged 40years, presented with cough, chest pain, weight loss and peripheral infiltration of right middle lobe on the chest radiograph and chest computed tomographic scans. We confirmed chronic eosinophilic pneumonia with bronchoalveolar lavage analysis and transbronchial lung biopsy. We herein report a lobal type of chronic eosinophilic pneumonia with a brief review of literature.
Adrenal Cortex Hormones ; Biopsy ; Bronchoalveolar Lavage ; Chest Pain ; Cough ; Diagnosis ; Eosinophils* ; Humans ; Lung ; Male ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence ; Thorax ; Weight Loss

BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) in children with asthma, not associated with cystic fibrosis, is yet to receive the recognition it deserves. OBJECTIVE: To highlight the presentation of ABPA in children with asthma. METHODS: This retrospective review documents the occurrence of pediatric ABPA over a period of 31 years in one unit. Children with asthma, eosinophilia and infiltrates on chest radiograph were screened for ABPA. In these patients, demonstration of immediate hypersensitivity response against Aspergillus species along with serological profile and pulmonary function testing were done. Bronchography/computed tomography (CT) of the chest demonstrated central bronchiectasis (CB). CT of the paranasal sinuses was done in patients with upper airways symptoms. In those suspected with allergic Aspergillus sinusitis (AAS) consent was sought from the parents for the invasive procedure needed for the diagnosis of AAS. RESULTS: Of the 349 patients with ABPA diagnosed, 42 (12.03%) were in the pediatric age group. The mean age on presentation was 12.9 ± 4 years with a male preponderance. All patients had asthma and positive intradermal/skin prick test against Aspergillus species. Ring shadows, the most common radiological presentation, were seen in 28 of 42 patients. Bronchography/CT of the chest demonstrated CB, a feature pathognomic of ABPA, in 32 of 42 patients. High attenuation mucus plugs was observed in 7 of 36 patients while ABPA-seropositive was diagnosed in 10 of 42 patients. On imaging, sinusitis was seen in 20 of 30 patients with upper airways symptoms of whom eight had suspected AAS. Three parents consented for surgery, which confirmed the diagnosis. CONCLUSION: This study highlights the need to evaluate asthmatic children for ABPA as also to exclude AAS.
Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Asthma ; Bronchiectasis ; Child ; Cystic Fibrosis ; Diagnosis ; Eosinophilia ; Humans ; Hypersensitivity, Immediate ; Male ; Mucus ; Paranasal Sinuses ; Parents ; Radiography, Thoracic ; Respiratory Function Tests ; Retrospective Studies ; Sinusitis ; Thorax