Table of Contents
Definition / general | Epidemiology | Sites | Pathophysiology | Etiology | Diagrams / tables | Clinical features | Radiology description | Radiology images | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Additional referencesCite this page: Asirvatham JR, Jorns JM. Cysticercosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastcysticercosis.html. Accessed January 22nd, 2021.
Definition / general
- Cysticercosis is caused by the larval form of Taenia solium (cysticercus cellulose) after ingestion of food contaminated with its eggs
Epidemiology
- Prevalent in Mexico, Africa, Southeast Asia, Eastern Europe, South America
- Common in rural areas of developing countries
Sites
- Common sites are the brain, skeletal muscles, heart and eye
- Cysticercosis of the breast is rare
- 8 cases were identified by FNAC over a 15 year period in India (Acta Cytol 1996;40:653)
Pathophysiology
Etiology
- Acquired by ingestion of tapeworm eggs transferred via the fecal oral route
Clinical features
- Cysticercosis of the breast may present as a cystic mass that may be freely mobile
Radiology description
- Radiology may reveal a cyst with or without mural nodule
- Calcification may be present
Case reports
- 15 year old girl with solitary breast cysticercosis (Med Trop (Mars) 2007;67:179)
- 32 year old woman with cysticercus of the breast which mimicked a fibroadenoma (J Clin Diagn Res 2012;6:1555)
- 35 year old woman with an incidental case associated with fibroadenoma (Indian J Pathol Microbiol 2001;44:59)
- 38 year old woman (Trop Parasitol 2013;3:148)
- 63 year old woman (Am J Trop Med Hyg 2008;79:864)
Treatment
- Albendazole, praziquantel
Gross description
- Cysts range from a few millimeters to 1 - 2 cm occasionally
- Viable cysts are translucent, through which a single scolex may be visible (2 - 3 mm nodule)
- As the cyst begins to degenerate, the fluid becomes dense and opaque
- In the later stages only a calcified nodule may be present
Gross images
Microscopic (histologic) description
- Multilayered cyst wall with a single invaginated scolex, which contains a rostellum, 4 suckers and 22 - 23 hooklets
- A host inflammatory reaction is usually not present if the larva is viable
- Cysticerci may remain viable for years
- Colloidal stage: first stage of involution of cysticerci; transparent vesicular fluid is replaced by a turbid, viscous fluid and the scolex shows signs of hyaline degeneration
- Granular stage: cysticercus is no longer viable; cyst wall thickens and the scolex is transformed into coarse mineralized granules
- Finally, a granulomatous reaction develops characterized by histiocytes, epitheloid cells and foreign body giant cells, leading to fibrosis of the supporting stroma and calcification of the parasitic debris
- Hooklets may persist for a long time
Microscopic (histologic) images
Cytology description
- Fibrillary material with interspersed small nuclei may be seen
- Parts of parasite may be identifiable (Acta Cytol 1996;40:653)
- The background usually consists of a mixed inflammatory infiltrate (Acta Cytol 1989;33:659)
- Granulomas may be seen
Cytology images
Positive stains
- Hooklets of cysticerci can be acid fast
Additional references