Necrotic granuloma of the liver by human fascioliasis: imaging findings

Abstract

We report a case of necrotic granuloma of the liver by human fascioliasis. The lesion showed unusual findings at sonography, computed tomography, and magnetic resonance imaging that have not been reported previously.

Hepatobiliary fascioliasis: a case with unusual radiological features

“…These lesions are mainly subcapsular and do not enhance on CT (5,13,14). Hepatic sonographic findings have been described as small clustered hypoechoic lesions with poorly defined contours and hypoechoic nodular lesions (6,(14)(15)(16).…”

Unusual Radiological Findings of <i>Fasciola Hepatica</i> Infection with Huge Cystic and Multilocular Lesions

“…However, some atypical radiographic findings have also been observed during acute or chronic fascioliasis (9,10). In the present case, a huge abscess-forming lesion and asymptomatic physical presentations with eosinophilia mimicked hepatic unilocular hydatid disease (11) …”

Diagnostic imaging in the study of human hepatobiliary fascioliasis

“…Owing to the lack of specific clinical symptoms, human fascioliasis needs to be differentiated from other hepatic and biliary diseases, including acute hepatitis, neoplasms, visceral toxoplasmosis, biliary amoebiasis or other larval infections of the liver such as schistosomiasis [8,9]. In the majority of cases, the diagnosis is difficult and is thus delayed both in the acute and chronic phases, as more common infections such as pyogenic liver abscesses and metastases are not easily distinguished from fascioliasis [10]. The diagnosis can be confirmed by the finding of eggs or larvae in the stool and by the detection of antilarval antibodies on the ELISA test, the sensitivity and specificity of which is approximately 90%.…”

“…A causa dell'assenza di specificità dei sintomi clinici, la fascioliasi umana deve essere distinta da altre malattie epatiche e biliari, come l'epatite acuta, le neoplasie, la toxoplasmosi viscerale, l'amebiasi del tratto biliare o altre infezioni epatiche da larva quali la schistosomiasi [8,9]. Infatti, nella grande maggioranza dei casi, la diagnosi è difficile e viene ritardata sia nella fase acuta che cronica, dato che affezioni più comuni come gli ascessi piogenici del fegato e le metastasi non sono facilmente distinguibili dalla fascioliasi [10]. La diagnosi può essere confermata dal rilevamento di uova o larve nelle feci e dal rinvenimento di anticorpi anti-larva nel siero attraverso il test ELISA, al quale si devono riconoscere sensibilità e specificità attorno al 90%.…”