case_images: PMC11234883_01
case_images: Bone marrow smear. Bone marrow smear showed increased red blood cells, scattered eosinophils infiltration (arrow), and MF grade 2 of reticulum fiber staining (A, H&E staining, 100x; B, H&E staining, 400x).
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case_images: fig1
case_images: Bone marrow biopsy showed increased red blood cells, scattered eosinophils infiltration, and MF grade 2 of reticulum fiber staining (Figure 1), which ruled out lymphocytic and myeloproliferative forms of hypereosinophilic syndrome.
case_images: Gastroscope and histology examination (2022/09/05). The gastroscope views showed erythema in the gastric antral mucosa (A), hyperemia and edema in the mucosa of gastroduodenal junction (B), and edema in the descending part of duodenum (C). Histology of the gastric antrum mucosa revealed chronic mucositis (D). Histology of the descending part of duodenum showed the villi structure of descending duodenum is near normal. Numerous eosinophils are evenly dispersed in the interstitium (>200 eos/hpf) (arrow); inflammatory infiltrates also contain macrophages, plasma cells, and scattered neutrophils (E).
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case_images: Histopathological analysis of intestinal mucosa biopsy specimens showed marked eosinophilic infiltration of the descending duodenum mucosa with more than 200 eosinophils per high-power field (Figure 2).
case_images: Histology examination of colon. The glandular structure of ascending colon was irregular, and the glandular epithelial cells were increased in layers and arranged disorderly, with severe hyperplasia of the nucleus and pathological nuclear fission, increased eosinophils are dispersed in the interstitium (A). The glands were crowded arrangement and confluent, some of them showed cribriform structure, increased cell layers, and moderate to severe nuclear dysplasia (B).
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case_images: fig3
case_images: Histopathological analysis of these polyps revealed tubular adenomas with pathological epithelial hyperplasia ranging from mild to severe, and increased eosinophils were dispersed in the interstitium (Figure 3).
case_images: Repeated Gastroscope examination (2022/12/09). The gastroscope views showed hyperemia in the gastric antral mucosa (A), no abnormality in the mucosa of duodenal bulb and upper part of pars descendent (B,C).
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case_images: fig4
case_images: The repeated gastroscope revealed chronic non-atrophic gastritis, mucosal repair improvement of the bulb, and descending duodenum (Figure 4).