Breast

Infectious

Cysticercosis

Authors: Jaya Ruth Asirvatham, M.B.B.S., Julie M. Jorns, M.D.

Topic Completed: 1 June 2014

Minor changes: 1 April 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Cysticercosis breast

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Table of Contents

Cite this page: Asirvatham JR, Jorns JM. Cysticercosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastcysticercosis.html. Accessed September 19th, 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

See: CDC: Parasites - Cysticercosis

Etiology

Acquired by ingestion of tapeworm eggs transferred via the fecal oral route

Diagrams / tables

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Diagram

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

Radiology images

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Cysts

Mammogram, tubular structure

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

AFIP images

Breast cyst

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Breast: tubular, worm-like structure

Oral cavity, well circumscribed nodule

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

Case #115

CNS

Eyelid

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Cyst wall enclosing structure

Cyst composed of 3 layers

Foreign body giant cell reaction

Larva enclosed in a thin fibrous cyst wall

Eye: cyst wall

Eye

Eye: hooklet of cysticercus

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

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