Sequential liver imaging in the hypereosinophilic syndrome: discordant images with scintigraphy, ultrasound, and computed tomography.

Sequential liver scintigrams in a patient with hypereosinophilic syndrome were used to demonstrate liver involvement initially and then to show progression of hepatic disease followed by gradual normalization on treatment. Computed tomography and ultrasound images of the liver were normal; thus, tissue density differences and sonar interfaces were apparently not sufficiently large for detection of tissue infiltrates, whereas abnormalities in Kupffer cell function resulted in abnormal scintigram images. A pattern of changing and vanishing filling defects on the scintigram while computed tomography and ultrasound images were normal was observed in the hypereosinophilic syndrome.