Volume 49/Number 3/Abstract 13
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Acta Parasitologica, Vol.49, No. 3, 2004, 266-267
Fulya Koybasioglu*, Ataturker Arikok, Evrim Ozturk and Binnur Uzmez Onal - Fine needle aspiration cytology in diagnosis of a subcutaneous echinococcal cyst

Department of Pathology and Cytology Unit/Social Security Foundation (SSK) Training Hospital, 06110 Ankara, Turkey
*Corresponding author: ffgk@yahoo.com

Fine needle aspiration cytology (FNAC) is not a routine investigation method in the diagnosis of cystic echinococcosis. In addition to a few published examples of hydatid cysts diagnosed by FNAC, our case confirms that FNAC may be an important diagnostic procedure in diagnosing hydatid cyst (WHO 2001, Baldi et al. 2002). In a 22 year old women, a subcutaneous, infraumblical mass, localized on abdominal wall, anterior to rectus abdominus muscle was detected. CT scan revealed a mass with regular outlines and thick wall consisting of a considerable amount of dense material (Fig. 1). In the operation room of General Surgery, using 21 gauge needle attached to a 10 ml-injector; FNA was applied to the mass by Zaijek technique (Nepka et al. 1999). Three ml of haemorrhagic material was obtained and centrifuged at speed of 1500 rpm for 10 min in Cytology Unit. From a depart two haematoxylin-eosin (HE) and one Papanicolaou (PAP) stained slides were prepared. Microscopic examination revealed multiple scolices and refractile transparent hooklets of Echinococcus against a dirty background (Figs 2 and 3). The diagnosis of hydatid cyst was made by these cytologic findings and the mass was totally excised. Examination of this surgical specimen revealed a fibrous capsule with a lamellated membrane. No cyst was detected in other organs by imaging techniques. Hydatid cyst is most common in liver and lungs, 84% of cystic echinococcosis cases. These two organs constitute the first two barriers during the migration of oncosphere in the human body. When the oncosphere passes these two barriers, it can be trapped in systemic capillaries anywhere in the body (Nepka et al. 1999). FNA cytology is a reliable method of diagnosing cystic echinococcosis even though it is not generally recommended as a diagnostic procedure since it is thought to cause an anaphylactic reaction and dissemination of the infection (Sodhani et al. 2002). However, to handle possible complications when punctioning a hydatid cyst, aspiration should be carried out under intensive care unit conditions by using the fine needle. Our case has not any complications.



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