Eosinophilia as a manifestation of gall bladder carcinoma – A case report

Eosinophilia represents an increase in eosinophils in the tissues or blood. Blood eosinophilia is charac-terized by an increase in the circulating absolute eosinophils above the normal level of 0.5×109/L. The aetiology of eosinophilia is diverse, encom-passing primary, reactive, and idiopathic causes, thereby presenting a significant diagnostic challenge for clinicians. Paraneoplastic eosinophilia, a rare subset of reactive eosinophilia, has been docu-mented in association with various hematologic and solid organ malignancies. This underscores the necessity for a thorough differential diagnosis when encountering hyper eosinophilia in patients, to identify potential underlying neoplastic processes.
We report a case of a 72-year-old man presenting with fever and constitutional symptoms was diag-nosed to have gallbladder carcinoma with extensive liver metastasis. The investigations revealed an absolute eosinophil count of 16.64×109 (38.7%) without any evidence of other cytopenia or abnor-mal cells in the blood picture. As there were no other apparent potential causes for reactive eosinophilia, this was strongly suggestive of a paraneoplastic eosinophilia associated with the underlying carcinoma. He succumbed to the illness two months later. This case report highlights the importance of considering paraneoplastic eosinophilia as a potential underlying cause when evaluating eosinophilia.