engleski

Eosinophilic gastroenteritis with pleural outflow and ascites. A case report

Introduction: In our region eosinophilic gastroenteritis is a very rare disease. Etiology is unknown. Case report: A 39-year-old female patient was admitted to the clinic due to slight cough, right side pleural outflow and ascites, without other symptoms. Gyanecological ultrasound, ultrasound of the upper abdomen, CT refer to ascites besides normal findings of abdominal and pelvic organs. Laboratory examinations were normal except peripheral eosinophilia and increased values of Ca 125. cytological findings of pleural outflow and ascites revealed a great number of eosinophilic granulocytes but without malignant cells. Patohistological findings: During explorative laparotomy resected parts of both ovaries, a lymph node, a hyperplastic part of pylorus, a knot from a small bowel designated as a tumor, and an appendix were taken out for a patohistological examination. Both ovaries reveal normal ovarial parenhima. A regional lymph node showed reactive changes with hyperplastic follicles and prominent germinative centres. The main histological finding reveal Pyloric stromal edema and a dense infiltrate of eosinophilic granulocytes throughout the muscle layer as well as eosinophils situated in perivascular spaces which is accompanied with swelling of endotelium of capillary blood vessels. Eosinophilic granulocytes were found in the smooth muscle layer of intestine as well as in the subserosal tissue. Lumen of the appendix was obliterated and the muscle layer and the subserosal tissue contzained eosinophils. Conclusion: From uor review it is visible that eosinophilic gastroenteritis can represent a great diagnostic problem especially when it is accompanied with pleural outflow and ascites and increasing values of tumor markers. That can possibly mislead a diagnostic procedure to the neoplastic rather than the immunological or allergic disease. Three years after surgery the patient is well.

eosinophilia

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