Focal Eosinophilic Necrosis Versus Metastasis in the Liver: The Usefulness of Two-Phase Dynamic CT
Jin Hur1,
Mi-Suk Park1,
Jeong-Sik Yu1,
Joon-Suk Lim1,
Soon Won Hong2 and
Ki Whang Kim1
1 Department of Diagnostic Radiology and Research Institute of Radiological
Science, Yonsei University College of Medicine and YongDong Severance
Hospital, 146-92, Dogok-Dong, Kangnam-Ku, Seoul 135-270, South Korea.
2 Department of Pathology, Yonsei University College of Medicine, Seoul, South
Korea.
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Fig. 1A. —Focal eosinophilic necrosis of liver in 36-year-old man with
early gastric cancer and peripheral eosinophilia (13%). Hepatic artery phase
CT image reveals isoattenuating lesion (arrow) in right hepatic lobe.
Mean lesion-to-liver contrast was 14 ± 7 H.
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Fig. 1B. —Focal eosinophilic necrosis of liver in 36-year-old man with
early gastric cancer and peripheral eosinophilia (13%). Corresponding portal
venous phase CT image shows more discrete, nonspherical hypoattenuating lesion
(arrow) without rim enhancement. Mean lesion-to-liver contrast was 36
± 8 H.
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Fig. 2A. —Metastasis from gastric cancer in 49-year-old man. Hepatic
artery phase CT scan reveals single focal hepatic lesion (arrow) with
discrete margin, spherical shape, and targetlike hypoattenuation in right lobe
of liver. Mean lesion-to-liver contrast was 28 ± 9 H.
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Fig. 2B. —Metastasis from gastric cancer in 49-year-old man.
Corresponding portal venous phase CT image shows hypoattenuating spherical
lesion (arrow) with discrete margin. Mean lesion-to-liver contrast
was 43 ± 8 H.
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Fig. 3A. —Focal eosinophilic necrosis of liver in 55-year-old man with
early gastric cancer. Peripheral eosinophilia was 50%. Hepatic arterial phase
CT image does not show any recognizable lesion.
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Fig. 3B. —Focal eosinophilic necrosis of liver in 55-year-old man with
early gastric cancer. Peripheral eosinophilia was 50%. Corresponding portal
venous phase CT image reveals multiple focal hypoattenuating hepatic lesions
(arrows) with indistinct margins and nonspherical shapes but without
rim enhancement.
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Fig. 3C. —Focal eosinophilic necrosis of liver in 55-year-old man with
early gastric cancer. Peripheral eosinophilia was 50%. Photomicrograph of core
needle biopsy specimen shows hepatocellular necrosis and innumerable
inflammatory cell infiltrates predominantly composed of eosinophils and
histiocytes. No tumor cell is identifiable. (H and E, x400)
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Fig. 4A. —Metastasis from colon cancer in 63-year-old man. Hepatic
arterial phase CT scan reveals discrete hypoattenuating lesion
(arrow) with rim enhancement in right lobe of liver.
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Fig. 4B. —Metastasis from colon cancer in 63-year-old man. Portal
venous phase CT scan at same level as A shows discrete hypoattenuating
lesion (arrow) with rim enhancement at same site.
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Copyright © 2005 by the American Roentgen Ray Society.
