Alveolar Echinococcosis Mimicking a Hepatic Neoplasm with Lymph Node Metastasis: A Case Report.

Abstract

A 37-year-old man had an asymptomatic 17-mm mass in the liver by health check with ultrasonography. Five years later, he was referred to our hospital because the mass was slightly enlarged with a peripancreatic lymph node. We performed endoscopic ultrasonography fine-needle aspiration (EUS-FNA) to evaluate a lymph node, but it showed amorphous eosinophilic material and eosinophilic infiltrate in necrotic tissue of toothpaste-like white specimen. However, we diagnosed as potentially malignant liver mass with lymph node metastasis because of 2-deoxy-2-(fluorine-18) fluorodeoxyglucose uptake. We then performed hepatectomy and enucleation of the pancreas. DNA polymerase chain reaction analysis revealed Echinococcus multilocularis infection. Retrospectively, we could find a part of Echinococcus in the specimens of EUS-FNA.

• Authors: Takahiro Amano, Shiro Hayashi, Tsutomu Nishida, Tokuhiro Matsubara, Kei Takahashi, Dai Nakamatsu, Yoshito Tomimaru, Masashi Yamamoto, Sachiko Nakajima, Koji Fukui, Hiromi Tamura, Shiro Adachi, Keizo Dono, Masami Inada
• Journal: Case reports in gastroenterology (Case Rep Gastroenterol) 2018 Sep-Dec Vol. 12 Issue 3 Pg. 587-596 ISSN: 1662-0631 [Print] Switzerland
• PMID: 30386197 (Publication Type: Case Reports)