Diagnosis of Cysticercosis in post auricular swelling on FNAC-A case report

Cysticercosis, a parasitic tissue infection is caused by larva of Taenia solium (Cysticercus cellulosae). Fine needle aspiration cytology (FNAC) provides direct, specific, simplest and early diagnosis of cysticercosis and remains one of the ideal diagnostic procedure wherever the lesion can be approached easily.

We present a case of 21 year old female presented with swelling on left postauricular area for one month, which was 2×1 cm, firm, tender and mobile. USG was suggestive of infective aetiology. FNAC was done using 24-gauge needle. Whitish blood mixed aspirate was seen. Smears were wet fixed with 95% ethyl alcohol and stained with Papanicolaou stain. Cytology smears showed fragments of bluish fibrillary material with interspersed small nuclei, which were seen against background of mixed inflammatory infiltrate of neutrophils, histiocytes, lymphocytes and eosinophils. Essential for diagnosis of cysticercosis are identification of parasitic fragments which may comprise bluish, fibrillary structures, sometimes with honeycombing, calcospherules, teguments, scolex with hooklets and hyaline membrane surrounding it.

Fine needle aspiration cytology is a low cost, outpatient procedure which helps in early diagnosis of cysticercosis. A careful search for parasitic fragments is to be made in presence of polymorphous inflammatory infiltrate composed predominantly of neutrophils, histiocytes and eosinophils.