Hepatic Visceral Larva Migrans of Toxocara canis: CT and Sonographic Findings
Samuel Chang1,
Jae Hoon Lim1,
Dongil Choi1,
Cheol Keun Park2,
Nam-Hee Kwon3,
Seung-Yull Cho4 and
Dong-Chull Choi3
1 Department of Radiology and Center for Imaging Science, Samsung Medical
Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku,
Seoul, South Korea 135-230.
2 Department of Pathology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, South Korea 135-230.
3 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School
of Medicine, Seoul, South Korea 135-230.
4 Department of Parasitology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, South Korea 135-230.
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Fig. 1A —44-year-old man with hepatic visceral larva migrans of
Toxocara canis. Transverse contrast-enhanced CT scan obtained at
arterial phase shows faint, rim-enhancing lesion (arrow) in Couinaud
segment VII of liver.
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Fig. 1B —44-year-old man with hepatic visceral larva migrans of
Toxocara canis. CT scan obtained at portal venous phase shows
multiple small, ill-defined, oval or elongated, low-attenuating lesions
scattered throughout liver.
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Fig. 1C —44-year-old man with hepatic visceral larva migrans of
Toxocara canis. CT scan at equilibrium phase shows barely visible
lesions.
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Fig. 1D —44-year-old man with hepatic visceral larva migrans of
Toxocara canis. Oblique subcostal sonogram of right lobe of liver
shows multiple, small, oval or elongated, hypoechoic lesions (arrows)
with indistinct margins.
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Fig. 2 —36-year-old man with subsegmental hepatic involvement of
visceral larva migrans of Toxocara canis. Transverse
contrast-enhanced CT scan obtained at portal venous phase shows multiple,
ill-defined, low-attenuating lesions at periphery of liver. Portal veins
(arrows) traverse lesions. Percutaneous liver biopsy disclosed
eosinophilic abscess.
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Fig. 3A —68-year-old man with hepatic visceral larva migrans of
Toxocara canis. Transverse contrast-enhanced CT scan obtained at
arterial phase shows small, ill-defined, enhancing nodule (long
arrow) in right hepatic lobe. Short arrow points to branch of portal
vein.
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Fig. 3B —68-year-old man with hepatic visceral larva migrans of
Toxocara canis. CT scan obtained at portal venous phase shows nodule
in A as low attenuating lesion (short arrow). Another
ill-defined lesion (long arrow) at anterolateral part of right lobe
is evident on portal venous phase image but not on arterial phase image.
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Fig. 3C —68-year-old man with hepatic visceral larva migrans of
Toxocara canis. Photomicrograph of needle biopsy specimen shows
eosinophilic abscess (arrowheads) and moderate to marked eosinophilic
infiltration (arrows) in hepatic sinusoids. (H and E, x100)
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Fig. 4A —42-year-old woman with hepatic visceral larva migrans of
Toxocara canis. Transverse contrast-enhanced CT scan obtained at
portal venous phase shows multiple small, ill-defined, oval or elongated,
low-attenuating nodules throughout liver.
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Fig. 4B —42-year-old woman with hepatic visceral larva migrans of
Toxocara canis. CT scan at same level as A 4 months after
A without antihelminthic treatment shows similar but fewer
low-attenuating nodules and different loci of lesions, suggesting migration of
larvae.
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Copyright © 2006 by the American Roentgen Ray Society.
