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Cunningham CR, Mehrsheikh AL, Aswani Y, Shetty AS, Itani M, Ballard DH, Khot R, Moshiri M, Picard MM, Northrup BE. Off the wall: incidental paraspinal and pelvic muscle pathology on abdominopelvic imaging. Abdom Radiol (NY) 2024:10.1007/s00261-024-04365-x. [PMID: 38831073 DOI: 10.1007/s00261-024-04365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 06/05/2024]
Abstract
As the use of cross-sectional abdominal and pelvic imaging has increased exponentially in the past several decades, incidental musculoskeletal findings have become commonplace. These are often unrelated to the indication for the examination and are frequently referred to as the "radiologist's blind spot" on these studies. The differential diagnosis for abnormalities of the paraspinal and pelvic musculature is, in many cases, quite different from the anterior abdominal wall muscles. Furthermore, due to their relatively deep location, pathology involving the former muscle groups is more likely to be clinically occult, often presenting only incidentally when the patient undergoes cross-sectional imaging. Effective treatment of diseases of these muscles is dependent on adherence to a diverse set of diagnostic and treatment algorithms. The purpose of this review article is to familiarize the radiologist with the unique pathology of these often-overlooked muscles of the abdomen and pelvis.
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Affiliation(s)
- Christopher R Cunningham
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA
| | - Amanda L Mehrsheikh
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA
| | - Yashant Aswani
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Anup S Shetty
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA
| | - Malak Itani
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA
| | - Rachita Khot
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Mariam Moshiri
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Melissa M Picard
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benjamin E Northrup
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, St. Louis, MO, 63110, USA.
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2
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Jyotsna M, Doomra R, Yadav SK. Isolated cysticercosis of breast mimicking a mass lesion: A case report. Int J Surg Case Rep 2023; 112:108956. [PMID: 37837663 PMCID: PMC10667779 DOI: 10.1016/j.ijscr.2023.108956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Cysticercosis is a zoonotic disease caused by the larval form of Taenia solium. Its occurrence as a breast lump is rarely observed and therefore presents significant diagnostic challenges, especially in non-endemic regions. CASE PRESENTATION A 25-year-old female patient presented with a lump in her left breast. The lesion was initially non-diagnostic on ultrasound and fine needle aspiration cytology. Excision biopsy of the cystic lesion was done, and histopathological examination confirmed it to be cysticercosis. Post surgery patient was given Albendazole, and she was asymptomatic during the 3 month follow up. CLINICAL DISCUSSION This case highlights the disease's ability to present in atypical forms, such as a breast lump, and the importance of considering cysticercosis in differential diagnosis, especially in endemic regions. Ultrasonography remains the preferred initial diagnostic modality, and the role of FNAC and histopathology is crucial for confirmation. The case also emphasizes the need for heightened clinical suspicion, even when traditional risk factors like pork consumption are absent. CONCLUSION This case emphasizes the importance of considering cysticercosis as a differential diagnosis for breast lumps, even with atypical presentation or in a non-endemic region. It highlights the need for greater awareness of this disease, stringent public health measures, and improved personal hygiene to combat its spread.
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Affiliation(s)
- Mili Jyotsna
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Rhythm Doomra
- All India Institute of Medical Sciences, Bhopal, India
| | - Shakti Kumar Yadav
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, India.
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3
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Kumar H C K, Narayana PS, Kumar KJ. Isolated Intramuscular Cysticercosis in Children: A Case Report. TURKIYE PARAZITOLOJII DERGISI 2022; 46:72-74. [PMID: 35232709 DOI: 10.4274/tpd.galenos.2020.6613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human cysticercosis is an emerging infection caused by the larvae of Taenia solium (Cysticercus cellulosae). The most common sites for cysticercosis are the central nervous system, subcutaneous tissues, eyes, and muscles. Isolated intramuscular cysticercosis without brain involvement is rare and only a few reports are available in children. Here, we report two children with isolated intramuscular cysticercosis who presented with the swellings that were diagnosed by ultrasonography and fine-needle aspiration cytology. Both of them responded well to steroids and albendazole treatment, showing a complete resolution of the swelling.
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Affiliation(s)
- Krishna Kumar H C
- JSS Academy of Higher Education and Research, JSS Medical College, Mysore, India
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4
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Mahalingam S, R G, Karn S, Dhar S, Purushothaman S. Role of Point-of-Care Ultrasound in Diagnosing Cysticercosis. Cureus 2021; 13:e17013. [PMID: 34540413 PMCID: PMC8424134 DOI: 10.7759/cureus.17013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/28/2022] Open
Abstract
Soft-tissue swelling is common in clinical practice and few common causes are lipoma, sebaceous cyst, abscess, etc. Though rare, myocutaneous cysticercosis can also be a differential. Point-of-care ultrasound (POCUS) can help diagnose myocutaneous cysticercosis, which can predict neurocysticercosis among patients presenting with headaches and seizures. Myocutaneous cysticercosis is often seen as a cystic lesion with eccentric hyperechoic foci (scolex) in ultrasound. Here, we describe a case of multiple swellings in the neck and forearm associated with headache, which turned out to be myocutaneous cysticercosis and neurocysticercosis, diagnosed with the help of ultrasound.
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Affiliation(s)
- Sasikumar Mahalingam
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Gunaseelan R
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Shivani Karn
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Shirshendu Dhar
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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5
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Isolated Intramuscular Cysticercosis—a Case Series. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03045-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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6
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Ravikanth R, Majumdar P. Isolated Intramuscular Cysticercosis of the Biceps Diagnosed on High-Resolution Ultrasonography. J Microsc Ultrastruct 2021; 9:39-40. [PMID: 33850711 PMCID: PMC8030538 DOI: 10.4103/jmau.jmau_59_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/22/2020] [Indexed: 11/24/2022] Open
Abstract
High-resolution ultrasound clinches the diagnosis of intramuscular cysticercosis which is a rare finding. Here, we present a case of isolated intramuscular cysticercosis diagnosed on high-resolution ultrasonography in a 46-year-old gentleman who presented with a linear swelling in the flexor aspect of the left arm in the long head of the biceps.
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Affiliation(s)
- Reddy Ravikanth
- Department of Radiology, Holy Family Hospital, Thodupuzha, Kerala, India
| | - Pooja Majumdar
- Department of Medicine, INHS Kalyani, Visakhapatnam, Andhra Pradesh, India
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Kumar A, Sharma A, Jayaram J, Hariprasad R. Cysticercosis of the Breast—a Case Report. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02538-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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8
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Latif A, Kapoor V, Weum B, Mirza M, Velagapudi M. A curious case of disseminated cysticercosis in an immunocompetent adult. Intractable Rare Dis Res 2019; 8:283-285. [PMID: 31890458 PMCID: PMC6929594 DOI: 10.5582/irdr.2019.01093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Cysticercosis is an infection with the larval stage of Taenia Solium which is estimated to affect over 50 million people worldwide. We report a case of disseminated cysticercosis in an immunocompetent 68-year-old male who presented with back pain, presumed to be musculoskeletal in nature initially. Magnetic-resonance-imaging of the lumbar spine revealed intramuscular (paraspinous and psoas muscles) cysts, innumerable small cystic lesions bilaterally throughout the cerebellar and cerebral hemispheres, midbrain, and right ventricle suggestive of cysticercosis. Treatment with albendazole with dexamethasone for 3 months led to resolution of the cysts with complete resolution of symptoms. Despite its importance, current data on prevalence of this infection, disease burden and the incidence of hospitalization remains incomplete. Mandatory reporting of diagnosis would enable complete understanding of epidemiology of the disease. In this case we have emphasized the importance of early diagnosis of a systemic condition that could have caused serious implications if left untreated.
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Affiliation(s)
- Azka Latif
- CHI Health Creighton University Medical Center - Bergan Mercy, Omaha, NE, USA
- Address correspondence to:Dr. Azka Latif, CHI Health Creighton University Medical Center - Bergan Mercy, 7500 Mercy Road, Omaha, NE 68124, USA. E-mail:
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9
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Neethu KC, Jain A, Haritha S. Cysticercosis Cellulosae Cutis: A Forgotten Entity. Indian Dermatol Online J 2019; 10:574-576. [PMID: 31544080 PMCID: PMC6743388 DOI: 10.4103/idoj.idoj_469_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cysticercosis cellulosa cutis is caused by larval stage of Taenia solium. It most commonly affects central nervous system, muscle, and subcutaneous tissue. Here, we report a case of 70-year-old female who was misdiagnosed on ultrasound as abscess and was treated with no improvement. Later, she was diagnosed on FNAC as cutaneous cysticercosis. Hence, we report this case because of its uncommon clinical presentation and diagnostic difficulty.
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Affiliation(s)
- Kanagala Chowdary Neethu
- Department of Dermatology, Dr Pinnamaneni Sidhartha Institute of Medical Sciences and Research Foundation, Chinaoutapali, Andhra Pradesh, India
| | - Akshay Jain
- Department of Dermatology, Dr Pinnamaneni Sidhartha Institute of Medical Sciences and Research Foundation, Chinaoutapali, Andhra Pradesh, India
| | - S Haritha
- Department of Dermatology, Dr Pinnamaneni Sidhartha Institute of Medical Sciences and Research Foundation, Chinaoutapali, Andhra Pradesh, India
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10
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Abstract
Cysticercosis is a systemic parasitic disease caused by larval stage of Taenia solium. It is the most common parasitic disease worldwide. It is potentially a dangerous systemic disease with variable clinical manifestations. It can be diagnosed by radiological imaging and serology but demonstration of parasitic larva by cytology or histopathology is still the gold standard. Fine needle aspiration cytology (FNAC) plays an important role in prompt diagnosis of this disease. Aim To study the role of FNAC in the diagnosis of cysticercosis. Materials and Methods This study included 30 patients presenting with palpable subcutaneous and intramuscular nodules at different sites. Fine needle aspiration was performed on these lesions and cytological features were analyzed. Subsequent excision biopsy was evaluated wherever possible. Results Thirty patients in the age group of 7-80 years presenting with subcutaneous and intramuscular nodules at various sites were studied. Majority of the patients were males. The most commonly affected sites were upper and lower extremities and abdominal wall. Most of the cases were clinically misdiagnosed as lipomas, neurofibromas, lymphadenitis, epidermal inclusion cyst, sialadenitis, and soft tissue tumors. On cytological examination of aspirate from the lesions, fragments of parasite were seen in a background of mixed inflammatory cell infiltrate. Histopathological correlation was available in 17 cases. Conclusion FNAC is a simple, sensitive, cost-effective, and rapid diagnostic tool for diagnosis of cysticercosis as cytological diagnosis is quite clear where the actual parasitic structures are identified in the smear.
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Affiliation(s)
- Subhash Bhardwaj
- Department of Pathology, Govt. Medical College, Jammu, Jammu and Kashmir, India
| | - Gousia Rather
- Department of Pathology, Govt. Medical College, Srinagar, Jammu and Kashmir, India
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11
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Hwang ZA, Suh KJ, Chen D, Chan WP, Wu JS. Imaging Features of Soft-Tissue Calcifications and Related Diseases: A Systematic Approach. Korean J Radiol 2018; 19:1147-1160. [PMID: 30386146 PMCID: PMC6201973 DOI: 10.3348/kjr.2018.19.6.1147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/08/2018] [Indexed: 02/05/2023] Open
Abstract
Soft-tissue calcification refers to a broad category of lesions. Calcifications are frequently identified by radiologists in daily practice. Using a simple algorithm based on the distribution pattern of the lesions and detailed clinical information, these calcified lesions can be systematically evaluated. The distribution pattern of the calcific deposits enables initial division into calcinosis circumscripta and calcinosis universalis. Using laboratory test results (serum calcium and phosphate levels) and clinical history, calcinosis circumscripta can be further categorized into four subtypes: dystrophic, iatrogenic, metastatic, and idiopathic calcification. This pictorial essay presents a systematic approach to the imaging features of soft-tissue calcifications and related diseases.
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Affiliation(s)
- Zhen-An Hwang
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Kyung Jin Suh
- Department of Radiology, Dongguk University Gyeongju Hospital, Gyeongju 38067, Korea
| | - Dillon Chen
- Department of Radiology, University of California, Davis, CA 95817, USA
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Jim S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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12
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Jaiswal P, Yadav YK, Jaiswal S, Bhasker N. Isolated cysticercosis involving the anterior abdominal wall: a rare case report. J Parasit Dis 2017; 41:578-579. [PMID: 28615882 DOI: 10.1007/s12639-016-0802-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 05/27/2016] [Indexed: 11/28/2022] Open
Abstract
Isolated cysticercosis of anterior abdominal wall without parasitosis of central nervous system is very rare and may mimic a tumor leading to diagnostic and therapeutic dilemma. Histopathological examination plays an important role in making a definitive diagnosis. Here we report a case of a 13-year old Muslim girl presenting with swelling and pain in left lower abdomen which was clinically diagnosed as lipoma. On histopathological examination cysticercus with surrounding inflammation was seen. Since cysticercosis is a preventable disease, early and accurate diagnosis is necessary for the reduction of disease burden in the endemic areas.
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Affiliation(s)
- Pooja Jaiswal
- Department of Pathology, Integral Institute of Medical Sciences and Research, 145-A-Block, South City, Lucknow, 226025 India
| | - Yogesh Kumar Yadav
- Department of Pathology, Integral Institute of Medical Sciences and Research, 145-A-Block, South City, Lucknow, 226025 India
| | | | - Nilam Bhasker
- Department of Pathology, Integral Institute of Medical Sciences and Research, 145-A-Block, South City, Lucknow, 226025 India
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13
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Naren Satya SM, Mayilvaganan KR, Amogh VN, Balakrishna BV, Gautam MS, Prathyusha IS. A Classic Case of Subcutaneous Cysticercosis: A Rare Case with Sonological Findings and Review of Literature. Pol J Radiol 2016; 81:478-482. [PMID: 27781073 PMCID: PMC5056536 DOI: 10.12659/pjr.898408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background Cysticercosis is a parasitic infection caused by the larval stages of the pork tapeworm, Taenia solium. The subcutaneous form of the disease is a relatively rare clinical entity. Despite its rarity, it is imperative for a radiologist to be aware of this subcutaneous form of the disease and its various radiological patterns while evaluating any subcutaneous swelling. In this paper, we aimed to describe a typical case of ‘subcutaneous cysticercosis involving the left anterior chest wall’ with high resolution ultrasound findings. We also discussed the role of other imaging modalities in a case of subcutaneous cysticercosis. To the best of our knowledge, our case is only the second documented case report of sonological evaluation of subcutaneous cysticercosis involving the left anterior chest wall and the first case with high resolution ultrasound images of the lesion. Case Report An 11-year-old male presented with a painless, subcutaneous swelling over the left anterior chest wall for the last 2 months. High resolution ultrasound showed a well-defined, thin-walled, cystic lesion with an eccentric, echogenic focus in the subcutaneous plane. On change of the posture of the patient, this focus showed mobility. The hypoechoic area surrounding this cyst showed significant exudative fluid collection with diffuse, floating echoes and thin, incomplete internal septations. The adjacent soft tissues were thickened and irregular, suggestive of edema. This was followed by an excision biopsy. Histopathological examination revealed cysticercus cellulose parasite with an extensive mixed inflammatory cell infiltrate in the surrounding tissue. The patient was also administered oral antihelminthic therapy. Repeat ultrasound examination at the end of this management regimen showed complete healing with no e/o any remnant or recurrent cystic lesion, abscess or edema in the subcutaneous plane. Conclusions Subcutaneous cysticercosis is a relatively rare form of cysticercosis but should always be born in mind during the evaluation of subcutaneous swellings. High resolution ultrasound is a valuable, safe, nonionizing, cost-effective, widely-available, and easily-reproducible imaging tool for diagnosis of subcutaneous cysticercosis. There is a wide spectrum of ultrasound patterns of subcutaneous cysticercosis. In classic cases with a cyst containing a scolex within and with a surrounding abscess, high resolution ultrasound should always be the primary mode of diagnosis, thus avoiding unnecessary fine needle aspiration cytologies.
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Affiliation(s)
- Srinivas M Naren Satya
- Department of Radiodiagnosis, MV Jayaram Medical College and Research Hospital, Bangalore Rural, India
| | | | - V N Amogh
- Department of Radiodiagnosis, MV Jayaram Medical College and Research Hospital, Bangalore Rural, India
| | - B V Balakrishna
- Department of Radiodiagnosis, MV Jayaram Medical College and Research Hospital, Bangalore Rural, India
| | | | - Ivvala Sai Prathyusha
- Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bengaluru, India
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Nagaraju RM, Bhimarao. High Resolution Ultrasound in Disseminated Soft Tissue, Muscular and Glandular Cysticercosis. J Clin Diagn Res 2016; 9:TJ01-2. [PMID: 26816969 DOI: 10.7860/jcdr/2015/14103.6873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 09/16/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Rashmi M Nagaraju
- Assistant Professor, Department of Radiodiagnosis, P K Das Institute of Medical Sciences , Palakkad, Kerala, India
| | - Bhimarao
- Senior Resident, Department of Radiodiagnosis, P K Das Institute of Medical Sciences , Palakkad, Kerala, India
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Ghimire PG, Ghimire P, Rana R. Spectrum of Typical and Atypical Clinico-Histopathological and Radiological Presentation of Soft Tissue and Muscular Cysticercosis in Mid-Western and Far-Western Region of Nepal. J Clin Diagn Res 2015; 9:EC01-3. [PMID: 26500910 DOI: 10.7860/jcdr/2015/13474.6474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 07/17/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Soft tissue and muscular involvement in cysticercosis is a relatively rarer presentation. MATERIALS AND METHODS Twenty seven histopathologically confirmed cases of soft tissue and muscular cysticercosis were collected and the clinical, radiological data was reviewed. RESULTS There was female predominance for the lesions (19 cases among 27 cases). The most common location for the lesion was in the arm (9 cases), thigh (4 cases), forearm (7 cases), abdominal wall (4 cases) followed by nape of the neck (2 cases). Lesion ranged from 8 mm to 5 cm in size. Ultrasound was diagnostic in 24 cases and inconclusive in three cases. Histopathologically, intact cyst wall was noted in 12 cases, scolex in 5 cases. Seven cases showed degenerating cyst wall surrounded by inflammatory cells, granulation tissue and fibrosis. CONCLUSION Fine needle aspiration cytology and histopathological assessment is prudent in the diagnosis of soft tissue and muscular cysticercosis in cases posing clinical diagnostic dilemma.
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Affiliation(s)
- Pragya Gautam Ghimire
- Lecturer, Department of Pathology, Nepalgunj Medical College and Teaching Hospital , Banke, Nepal
| | - Prasanna Ghimire
- Assistant Professor, Department of Radiology, Nepalgunj Medical College and Teaching Hospital , Banke, Nepal
| | - Reena Rana
- Lecturer, Department of Pathology, Nepalgunj Medical College and Teaching Hospital , Banke, Nepal
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Sohoni CA. Isolated Cysticercosis Lump over Thigh in a Child. APSP J Case Rep 2015; 6:21. [PMID: 26064811 PMCID: PMC4448104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/25/2015] [Indexed: 10/28/2022] Open
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Chaudhary V, Bano S, Kumar P, Narula MK, Anand R. Hepatic cysticercosis: a rare entity. ABDOMINAL IMAGING 2014; 39:1182-1185. [PMID: 24806312 DOI: 10.1007/s00261-014-0152-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hepatic cysticercosis is a very rare entity; only four cases have been reported to date. High-resolution ultrasonography of the abdomen is the initial and most reliable modality for evaluation of hepatic cysticercosis. Medical therapy is the mainstay of treatment. We report a case of hepatic cysticercosis in a 28-year-old male who presented with right upper quadrant pain, fever, and jaundice. The article also describes the imaging patterns of hepatic cysticercosis based on different stages of evolution.
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Affiliation(s)
- Vikas Chaudhary
- Department of Radiodiagnosis, Employees' State Insurance Corporation (ESIC) Model Hospital, Sector-9A, Gurgaon, 122001, Haryana, India,
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Muthyala S, Krishna KV, Kishan TV, Sri Bhuvana N, Moorthy RS. Masseteric cysticercosis with abscess formation: A diagnostic dilemma. Med J Armed Forces India 2013; 71:S148-51. [PMID: 26265813 DOI: 10.1016/j.mjafi.2013.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/25/2013] [Indexed: 11/24/2022] Open
Affiliation(s)
- Swathi Muthyala
- Junior Resident (Radiology), Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India
| | - Kotha Vamshi Krishna
- Assistant Professor (Radiology), Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India
| | - Tatikonda Venkat Kishan
- Senior Resident (Radiology), Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India
| | - Nuthalapati Sri Bhuvana
- Junior Resident (Radiology), Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India
| | - R S Moorthy
- Professor and Head (Radiology), Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India
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Sinha S, Tiwari A, Sarin YK, Khurana N. Isolated soft tissue cysticercosis involving the trunk in children: report of 4 cases. APSP J Case Rep 2013; 4:35. [PMID: 24381831 PMCID: PMC3863824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 12/14/2012] [Indexed: 11/23/2022] Open
Abstract
Isolated soft tissue cysticercosis of the trunk in the absence of concurrent central nervous system involvement is uncommon and may be difficult to diagnose. We report 4 such cases in the pediatric age group. Preoperative diagnosis of soft tissue cysticercosis was considered only in 1 patient, the rest were diagnosed only after biopsy. Complete excision (without rupture) was done. All of them underwent a CT scan head along with ophthalmic examination to rule out the more common sites of occurrence of cysticercosis. No further treatment was undertaken as the evaluation was negative. In endemic areas like ours we must suspect this entity not only in the limb muscles, but also in the subcutaneous tissues of the trunk. If diagnosed accurately, it can be treated medically, eliminating the need for surgery.
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Affiliation(s)
- Shalini Sinha
- Dept. of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Abhishek Tiwari
- Dept. of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Yogesh Kumar Sarin
- Dept. of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Dept. of Pathology, Maulana Azad Medical College, New Delhi, India
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Tripathy SK, Sen RK, Akkina N, Hampannavar A, Tahasildar N, Limaye R. Role of ultrasonography and magnetic resonance imaging in the diagnosis of intramuscular cysticercosis. Skeletal Radiol 2012; 41:1061-6. [PMID: 22101866 DOI: 10.1007/s00256-011-1320-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 10/22/2011] [Accepted: 10/25/2011] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Nonspecific clinical presentations often lead to misdiagnosis of focal cysticercal myositis. This report emphasizes the role of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of solitary intramuscular cysticercosis. MATERIALS AND METHODS Six patients with persistent post-traumatic isolated muscular swelling were treated with analgesic and antibiotics, but the swelling did not subside. Radiographs showed soft tissue swelling with no bony abnormalities. Laboratory markers were inconclusive. Ultrasonographic and magnetic resonance images (MRI) showed typical features of intramuscular cysticercosis. Clinical, radiological, and fundoscopic evaluation of brain and eyes could not isolate any cysticercosis focus in these organs. Patients were treated with 3 weeks albendazole therapy. RESULTS The identifying sonographic features of intramuscular cysticercosis, as evident from this case series, included an intramuscular elliptical or oval anechoic lesion with echogenic intralesional focus likely to be scolex. Magnetic resonance images showed orientation of the cyst along the direction of muscle fibers with T2W hyperintense signal and post-contrast perilesional enhancement. All patients responded to medical treatment. CONCLUSION Cysticercosis may manifest as isolated muscular swelling without neurological or ocular involvement. Clinicians should be aware of this clinical condition to avoid misdiagnosis. Ultrasonography and magnetic resonance imaging are good diagnostic aids to establish soft tissue cysticercosis.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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