Hepatic visceral larva migrans of Toxocara canis: CT and sonographic findings.

OBJECTIVE The aim of this study was to describe the CT and sonographic findings of hepatic visceral larva migrans of Toxocara canis. MATERIALS AND METHODS Fifty-four patients (44 men, 10 women; age range, 30-80 years; mean age, 53 years) with serologically confirmed visceral larva migrans of Toxocara canis underwent evaluation of the liver with CT (n = 25), sonography (n = 48), or both. Two radiologists used consensus for retrospective evaluation of CT and sonographic findings. Correlation between the presence and severity of hepatic abnormalities on images and the degree of peripheral eosinophilia was assessed. RESULTS Seventeen (68%) of 25 patients who underwent CT had single or multiple ill-defined, oval or elongated, small, low-attenuating lesions in the liver. Eighteen (38%) of 48 patients who underwent sonography had single or multiple small, poorly defined, oval or elongated, hypoechoic scattered focal lesions in the liver. In the 19 patients who underwent both CT and sonography, the two techniques had no significant difference in rate of detection of hepatic lesions (p = 0.375, McNemar test). The lesion numbers on CT and sonography showed excellent linear correlation (r = 0.844, p = 0.001) by Pearson's correlation test. An independent samples t test showed that eosinophil count and percentage in the peripheral blood were significantly higher in patients with hepatic lesions on CT and sonography than in patients without lesions. CONCLUSION CT and sonographic findings of hepatic visceral larva migrans of T. canis are multiple, ill-defined, oval or elongated, small, nodular lesions scattered in the liver parenchyma. The presence of hepatic lesions on images was associated with higher peripheral eosinophil count and percentage.

[1]  C. Kapel,et al.  Zoonotic risk of Toxocara canis infection through consumption of pig or poultry viscera. , 2004, Veterinary parasitology.

[2]  M. Berry,et al.  Hepatic granulomas due to visceral larva migrans in adults: Appearance on US and MRI , 1994, Abdominal Imaging.

[3]  B. I. Choi,et al.  Focal eosinophilic infiltration in the liver: radiologic findings and clinical course , 2003, Abdominal Imaging.

[4]  J. H. Lim,et al.  Focal Eosinophilic Necrosis of the Liver in Patients with Underlying Gastric or Colorectal Cancer: CT Differentiation from Metastasis , 2002, Korean journal of radiology.

[5]  K. Ishak,et al.  Eosinophilic Granuloma of the Liver: A Characteristic Lesion With Relationship to Visceral Larva Migrans , 2001, The American journal of surgical pathology.

[6]  M. Hartleb,et al.  Severe hepatic involvement in visceral larva migrans. , 2001, European journal of gastroenterology & hepatology.

[7]  N. Radman,et al.  Human toxocarosis. Its seroprevalence in the city of La Plata. , 2000, Memorias do Instituto Oswaldo Cruz.

[8]  J. H. Lim,et al.  Hypereosinophilic Syndrome: CT Findings in Patients with Hepatic Lobar or Segmental Involvement , 2000, Korean journal of radiology.

[9]  S. Hirono,et al.  Hepatic imaging studies on patients with visceral larva migrans due to probable Ascaris suum infection , 1999, Abdominal Imaging.

[10]  K. Lee,et al.  Hepatic involvement in hypereosinophilia: sonographic findings. , 1999, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[11]  H. Yoo,et al.  Focal eosinophilic infiltration of the liver: a mimick of hepatic metastasis , 1999, Abdominal Imaging.

[12]  S. H. Choi,et al.  Foci of eosinophil-related necrosis in the liver: imaging findings and correlation with eosinophilia. , 1999, AJR. American journal of roentgenology.

[13]  M. Baldisserotto,et al.  Ultrasound findings in children with toxocariasis: report on 18 cases , 1999, Pediatric Radiology.

[14]  V. Nobre,et al.  Visceral larva migrans syndrome complicated by liver abscess. , 1999, Scandinavian journal of infectious diseases.

[15]  S. Sarin,et al.  Hepatic visceral larva migrans: evolution of the lesion, diagnosis, and role of high-dose albendazole therapy. , 1994, The American journal of gastroenterology.

[16]  Mak Jw,et al.  ELISA seropositivity for Toxocara canis antibodies in Malaysia, 1989-1991. , 1993 .

[17]  D. Kang,et al.  Hypereosinophilic syndrome: imaging findings in patients with hepatic involvement. , 1993, AJR. American journal of roentgenology.

[18]  J. Kudo,et al.  Hepatic granuloma in toxocaral infection: Role of ultrasonography in hypereosinophilia , 1992, Journal of clinical ultrasound : JCU.

[19]  B. Gottstein,et al.  Immunodiagnosis of toxocarosis in humans: evaluation of a new enzyme-linked immunosorbent assay kit , 1991, Journal of clinical microbiology.

[20]  Yong-Guo Li,et al.  Demonstration of hepatic granuloma due to visceral larva migrans by ultrasonography , 1990, Journal of clinical ultrasound : JCU.

[21]  L. Glickman,et al.  Visceral larva migrans in French adults: a new disease syndrome? , 1987, American journal of epidemiology.

[22]  T. Fujimura,et al.  Malignant tumor and eosinophils: I. Prognostic significance in gastric cancer , 1986, Cancer.

[23]  L. Glickman,et al.  Evaluation of serodiagnostic tests for visceral larva migrans. , 1978, The American journal of tropical medicine and hygiene.

[24]  L. Glickman,et al.  Toxocaral visceral larva migrans. , 1978, The New England journal of medicine.

[25]  K. Rodan,et al.  Infection with Adult Toxocara cati , 1969, British medical journal.

[26]  P. Beaver The nature of visceral larva migrans. , 1969, The Journal of parasitology.

[27]  P. Beaver Larva migrans. , 1956, Experimental parasitology.

[28]  P. Beaver,et al.  Chronic eosinophilia due to visceral larva migrans; report of three cases. , 1952, Pediatrics.