ABSTRACT
Cysticercosis is caused by a parasitic tissue infection caused by encysted larval form of tape worm Taenia solium and usually presents as painless subcutaneous or intramuscular nodules of long duration. It is quite a common disease worldwide, but the actual incidence is often underestimated. Fine needle aspiration cytology plays an important role in quick and easy detection of cysticercosis especially in easily approachable sites like superficial palpable lesions. We wanted to study the important role of FNAC in unusual diagnosis of cysticercosis in superficial palpable swelling. METHODSIn this case series of 15 cases of palpable nodular lesions at different sites, clinically diagnosed as lipoma, neurofibroma, inclusion cyst or lymphadenopathy in majority of cases, except one which was clinically and radiologically suspected as parasitic cyst were included. Cytomorphological features were analysed on FNAC smears and subsequent biopsy was done wherever possible. RESULTSIn this study, out of 15 cases, majority of the patients were in the age group of 20 - 30 years. Mean age is 23.93 years with a standard deviation of 11.17. Among them, 10 were male (66.6%) and 5 were female (33.3%). The most common sites were upper and lower extremities, followed by head and neck, and then abdominal wall. Most of the cases were clinically misdiagnosed as lymphadenitis, lipoma, neurofibroma, inclusion cyst or soft tissue tumour. Definitive diagnosis could be made on FNAC by recognition of parasitic fragments in nine cases (60%). In rest 6 cases (40%), larval fragments could not be identified on cytology smears and diagnosis of parasitic infection was suggested on the basis of nature of aspirate as clear fluid, eosinophils infiltration, palisaded histiocytes, foreign body giant cells, epithelioid cells, and dirty granular background. Histopathological correlation was available in 4 cases. CONCLUSIONSSubcutaneous cysticercosis can be diagnosed by FNAC which is a low cost safe outpatient procedure. The cytological diagnosis is straight forward in cases where parasitic structure is identified in cytology smears. In other cases, presence of eosinophils, palisaded histiocytes, typical granular dirty background always give a clue to the pathologist to become suspicious for cysticercosis. Cysticercosis should always be kept in mind as a differential diagnosis in all kinds of subcutaneous swellings in endemic areas.