Dilemmas in cytodiagnosis of subcutaneous swellings: mimics and look-alikes of cysticercosis.

BACKGROUND

Fine needle aspiration (FNA) is the modality of choice in the initial characterisation of subcutaneous swellings. The site, distribution, number and clinical association of such swellings determines to a large extent the clinical diagnoses rendered in these cases.

AIMS AND METHODS

15 unusual cases of subcutaneous cysticercosis, diagnosed by FNA, which clinically simulated diverse aetiologies, are reported.

RESULTS

Three cases occurred in patients with known malignancies which were thought to be metastatic deposits. In another nine cases the clinical diagnoses included lymphoma, squamous cell carcinoma, neurofibroma and lipoma. Two cases strongly mimicked tubercular lymphadenitis, while one case occurred in a renal transplant recipient.

CONCLUSIONS

FNA may help diagnosis of a parasitic aetiology in cases where malignancy or tuberculosis is a clinical probability. Cysticercosis should be an integral part of the differential diagnosis of all subcutaneous swellings, regardless of the clinical setting. Helpful cytological clues are discussed.