Fine needle aspiration in the diagnosis of subcutaneous cysticercosis

Human cysticercosis commonly manifests as subcutaneous and intramuscular nodules. The current study highlights the role of fine needle aspiration cytology (FNAC) in the diagnosis of subcutaneous cysticercosis. One hundred and twenty two patients with subcutaneous swellings, diagnosed as cysticercus or suspicious of parasitic inflammation on FNAC, were included in the present study. The relevant clinical data, cytomorphological findings, and histopathological findings, wherever available were evaluated. In 57 cases, a definite evidence of cysticercus was obtained in the form of fragments of parasite bladder wall, hooklets, or intact larva. Out of these, biopsy correlation was available in 10 cases, eight of which failed to reveal any parasite. In 65 cases, larval fragments could not be identified on aspirates, and the diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings, which are discussed. In 22 of these cases, a biopsy correlation was available, which revealed definite parasitic elements in six cases and the remaining 16 cases were reported as suggestive of parasitic cysts. Thus, to conclude, FNAC is a reliable and cost effective procedure for the diagnosis of subcutaneous parasitic nodules. It obviates the need for a subsequent histopathological examination, as the parasite may not be demonstrated even on biopsy specimens.