Hypereosinophilic syndrome appearing as a focal defect on liver scan

The case reported here is of a 34-year-old man diagnosed as having hypereosinophilic syndrome. Blood tests showed a large increase in the number of eosinophils and a slight increase in aspartate aminotransferase and alkaline phosphatase. In scintigraphy of the liver with Tc-99m-phytate and with Ga-67-citrate, a focal defect was found in the outer part of the right lobe of the liver. Abdominal computed tomography showed a low density lesion in the same area. Histological inspection of the biopsy specimen showed heavy periportal infiltration with eosinophils. The results suggested that the focal defect seen in liver scintigraphy arose from a circulatory disturbance arising from infiltration by eosinophils.