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Unsuspected isolated breast hydatidosis: a cytological diagnosis

Smears of the aspirate were stained with May– Grunwald–Giemsa (MGG), haematoxylin and eosin (H&E) and Ziehl–Neelson stains. The syringe and the needle containing the remaining aspirate were sent for mycobacterial culture on a suspicion of tuberculosis. The smears comprised of mainly polymorphs, histiocytes, many scattered eosinophils in a necrotic background. Many proliferating capillary channels were also seen. One of the MGG stained smears showed fragment of cysticercus with a scolex, suckers and hooklets (Figures 1 and 2). Thus, a diagnosis of subcutaneous cysticercosis was made. The cytological findings in the fine needle aspirate of cysticercosis presenting as a palpable nodule are identification of parasitic fragments. These include bluish fibrillary structures sometimes with honeycombing, tegument of parasite thrown into rounded wavy folds, and the scolex with hooklets and hyaline membrane surrounding it. The inflammatory reaction consists of eosinophils, neutrophils, lymphocytes, histiocytes, epithelioid cells and giant cells in varying proportions. Identification of fragments of an invaginated larva (i.e. hooklets, scolex or spiral wall) for establishing the diagnosis in FNAC smears is not always possible. Sometimes scattered spiked spherules are seen in these cases admixed with inflammatory cells suggesting cysticercosis. Therefore, a careful search for fragments of the invaginated portion of the larva should be made in necrotic lesions with eosinophils.