Fine-needle aspiration cytology as a diagnostic modality for cysticercosis: A clinicocytological study of 137 cases

The hidden threat of cysticercosis: A neglected public health problem

The parasitic infection known as cysticercosis is caused by the larvae of the Taenia solium (pork tapeworm). Cysticercosis is spread by food. Humans can serve as both definitive and intermediate hosts, whereas pigs serve as intermediate hosts. This illness is one of the neglected tropical diseases that affect the public health of people from low-income backgrounds. Cysticercosis is endemic to Africa, China, India, Southeast Asia, and Latin America. When humans consume pork that has been contaminated and cooked incorrectly, cysticerci enter the small intestine where they are evaginated by digestive enzymes and stick to the intestinal wall. Cysticerci can reside in the host tissues of both humans and pigs without causing illness or inflammation. Cysts are most frequently observed in the cerebral hemispheres, particularly where gray and white matter meet. Cysticerci typically build nests in the muscles and subcutaneous fat of pigs. This parasite typically causes neurocysticercosis, a pleomorphic clinical condition, in humans by infecting the central nervous system. Neuroimaging, serological tests, and a thorough clinical examination are good methods for diagnosing cysticercosis. An infection with T. solium tapeworm can be transmitted by eating raw or undercooked pork that has been infected. Individuals with pork tapeworms in their intestinal lumen, pigs, poverty, and cultural factors are the main causes of this disease. It is possible to treat human tapeworm infections with niclosamide. Cysticercosis has been eliminated in more through improved sanitation and restrictions on domestic pig husbandry.

Cysticercosis: A case of missed diagnosis

Human cysticercosis caused by the larval stage of the pork tapeworm-Taenia solium, is a potentially dangerous systemic disease with vague clinical manifestations. Subcutaneous and muscular tissues are most commonly involved followed by, the eye and brain. A variety of clinical presentations, pathology that ranges from simple cysts to calcified lesions, and limited familiarity with the parasitic infection can make it challenging to diagnose. Cysticercosis when present as an isolated lesion. Fine needle aspiration cytology (FNAC) can play an important role in the early and rapid detection of this disease, particularly when the lesion is superficial and /or easily sampled. We report a case of cysticercosis diagnosed on FNAC in a 35-year-old female, who presented with an isolated swelling in the neck.

Cytomorphological spectrum of cysticercosis: A study of 26 cases

BACKGROUND

Cysticercosis is a systemic parasitic disease caused by the larval stage of Taenia solium. It is the most common parasitic disease worldwide. Fine needle aspiration cytology can play an important role in prompt recognition of this disease.

OBJECTIVE

To study the role of FNAC in the diagnosis of cysticercosis.

MATERIALS AND METHODS

This study included 26 patients with parasitic infestation who presented with palpable subcutaneous and intramuscular nodules at different sites. Their clinical presentations and fine needle aspiration cytomorphological features are reported.

RESULTS

The age range of these patients was 7-60 years. The majority were males. The most commonly affected site was head and neck followed by upper extremity. Most of the cases were clinically misdiagnosed as lipomas, neurofibromas, lymphadenitis, epidermal inclusion cyst, sialadenitis, and soft tissue tumours. The aspirate was clear fluid in the majority of cases. All of the cases revealed fragments of bladder wall with associated granulomas in seven cases and giant cells in four cases. However, none of the case revealed hooklets.

CONCLUSION

Fine needle aspiration cytology can provide a simple, minimally invasive, low-cost, outpatient diagnostic technique for the diagnosis of cysticercosis, as cytological diagnosis is quite clear when the actual parasitic structures are identified in the smear.

Cysticercosis Cellulosae Cutis: A Forgotten Entity

Cysticercosis cellulosa cutis is caused by larval stage of Taenia solium. It most commonly affects central nervous system, muscle, and subcutaneous tissue. Here, we report a case of 70-year-old female who was misdiagnosed on ultrasound as abscess and was treated with no improvement. Later, she was diagnosed on FNAC as cutaneous cysticercosis. Hence, we report this case because of its uncommon clinical presentation and diagnostic difficulty.

Fine needle aspiration as a diagnostic tool in cysticercosis: a case series

BACKGROUND

Cysticercosis is a zoonotic disease. It is caused by the larval form of the pork tapeworm Taenia solium. This disease is a public health problem in a country like India, but its incidence is underestimated. With the advent of fine needle aspiration cytology with rapid on-site evaluation, early detection of this disease is possible, especially when the lesion is in anatomically approachable superficial locations.

CASE REPORT

We had four cases of cysticercosis diagnosed by fine needle aspiration cytology with on-site evaluation using toluidine blue stain, followed by Giemsa and Papanicolaou stain. Our cases included three Hindu male patients of age 30 years, 23 years, 17 years and an 26 year old Hindu female.

CONCLUSION

Fine needle aspiration cytology diagnosis of cysticercosis can be easily made provided the reporting cytologist is aware of the morphological criteria. Rapid on-site evaluation can further help in taking additional material and caution during staining process.

Fine Needle Aspiration Cytology of Cysticercosis: A Study of 30 Cases

Cysticercosis is a systemic parasitic disease caused by larval stage of Taenia solium. It is the most common parasitic disease worldwide. It is potentially a dangerous systemic disease with variable clinical manifestations. It can be diagnosed by radiological imaging and serology but demonstration of parasitic larva by cytology or histopathology is still the gold standard. Fine needle aspiration cytology (FNAC) plays an important role in prompt diagnosis of this disease.

Aim

To study the role of FNAC in the diagnosis of cysticercosis.

Materials and Methods

This study included 30 patients presenting with palpable subcutaneous and intramuscular nodules at different sites. Fine needle aspiration was performed on these lesions and cytological features were analyzed. Subsequent excision biopsy was evaluated wherever possible.

Results

Thirty patients in the age group of 7-80 years presenting with subcutaneous and intramuscular nodules at various sites were studied. Majority of the patients were males. The most commonly affected sites were upper and lower extremities and abdominal wall. Most of the cases were clinically misdiagnosed as lipomas, neurofibromas, lymphadenitis, epidermal inclusion cyst, sialadenitis, and soft tissue tumors. On cytological examination of aspirate from the lesions, fragments of parasite were seen in a background of mixed inflammatory cell infiltrate. Histopathological correlation was available in 17 cases.

Conclusion

FNAC is a simple, sensitive, cost-effective, and rapid diagnostic tool for diagnosis of cysticercosis as cytological diagnosis is quite clear where the actual parasitic structures are identified in the smear.

Cytological diagnosis of cysticercosis: Role of FNAC with On-Site evaluation

Cysticercosis is a zoonotic disease, caused by the larval form of pork tapeworm Taenia solium. This disease is a public health problem in a country such as India, but its incidence is likely underestimated. With the advent of fine needle aspiration cytology (FNAC) with rapid on-site evaluation (ROSE), early detection of this disease is possible, especially when the lesion is in anatomically approachable superficial locations. We report a case of cysticercosis confirmed by FNAC in the Department of Pathology where ROSE using toluidine blue was done as a part of routine cytology procedure. FNAC diagnosis of cysticercosis can be easily made provided the reporting cytologist is aware of the morphological criteria.

Spectrum of Typical and Atypical Clinico-Histopathological and Radiological Presentation of Soft Tissue and Muscular Cysticercosis in Mid-Western and Far-Western Region of Nepal

INTRODUCTION

Soft tissue and muscular involvement in cysticercosis is a relatively rarer presentation.

MATERIALS AND METHODS

Twenty seven histopathologically confirmed cases of soft tissue and muscular cysticercosis were collected and the clinical, radiological data was reviewed.

RESULTS

There was female predominance for the lesions (19 cases among 27 cases). The most common location for the lesion was in the arm (9 cases), thigh (4 cases), forearm (7 cases), abdominal wall (4 cases) followed by nape of the neck (2 cases). Lesion ranged from 8 mm to 5 cm in size. Ultrasound was diagnostic in 24 cases and inconclusive in three cases. Histopathologically, intact cyst wall was noted in 12 cases, scolex in 5 cases. Seven cases showed degenerating cyst wall surrounded by inflammatory cells, granulation tissue and fibrosis.

CONCLUSION

Fine needle aspiration cytology and histopathological assessment is prudent in the diagnosis of soft tissue and muscular cysticercosis in cases posing clinical diagnostic dilemma.