Fine needle aspiration cytology of subcutaneous cysticercosis: a study of 16 cases

Abstract

Background: Cysticercosis is an important parasitic infection more prevalent in developing countries. Fine needle aspiration cytology (FNAC) is an easy, low cost and fairly accurate method in diagnosing the disease. The main objective is to study the clinico-cytological profile of patients diagnosed with cysticercosis cellulosae.

Methods: The present study was descriptive observational cross sectional study done over a period of four years during which FNAC was done in patients presenting with subcutaneous and intramuscular nodules at various sites.  After detailed clinical history and clinical examination, the character of aspirate was noted. In each case, three alcohol fixed smears were prepared, first smear was stained with Papanicolaou stain, second with Giemsa stain and third one was kept unstained for any further required stain. Subsequent excision biopsy was also performed in patients suspected to have cysticercosis.

Results: A total of 16 cases of cysticercosis were diagnosed on FNAC and subsequently confirmed by excision biopsy over a four year period. Out of the 16 cases 11 (68.7%) were females and 5 (31.3%) were males. The mean age at diagnosis was 24 years. Most common site of involvement was upper extremity followed by neck. In most cases provisional clinical diagnosis was lipoma. In 10 cases out of 16 cases, actual parasitic structures were demonstrated. Only one case showed presence of hooklet. 5 cases showed presence of only acellular granular material with no parasite. The background population in most of the cases were predominantly eosinophils, lymphocytes, neutrophils   with multinucleated giant cells in some cases.

Conclusions: The high accuracy coupled with low cost and quick results make FNAC an important outpatient procedure for diagnosis of cysticercosis. In any soft tissue nodular swelling, possibility of cysticercosis must be kept in mind, especially in endemic areas.