Cytomorphology of subcutaneous cysticercosis. A report of 10 cases

The findings of fine needle aspiration cytology (FNAC) of subcutaneous cysticercosis are described. Nine patients had a single subcutaneous nodule. One patient had multiple skin and cerebral nodules that were clinically suspected due to cysticercus. Patients with a single nodule in the extremities and trunk were clinically diagnosed as having lipoma (1), fibroma (3) and neurofibroma (3). Tuberculous lymphadenitis was suspected in two cases with a single cervical nodule. The characteristic cytomorphology of parasitic tegument and parenchyma helped identify the larvae in the cytological smears, as did a polymorphous inflammatory reaction. Biopsy was done in four cases. Six patients were lost to follow-up. Histopathology of the nonaspirated nodule from the case with multiple skin nodules showed cysticercus. The other three biopsies showed a parasitic granuloma only. Of the four biopsied cases, only two underwent computed tomographic scans, which showed cerebral involvement. In a developing country like India, a rapid, safe and reliable cytologic diagnosis of subcutaneous cysticercus by FNAC on an outpatient basis proves to be a cost-effective procedure since it obviates the need for open biopsy.