Skin-nontumor
Infectious disorders
Cysticercosis

Author: Abha Soni, D.O., M.P.H. (see Authors page)
Editor: Andrzej Slominski, M.D., Ph.D.

Revised:23 May 2016, last major update January 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Cysticercosis [title] skin
Cite this page: Cysticercosis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/skinnontumorcysticercosis.html. Accessed December 13th, 2017.
Definition / general
  • Tissue infection caused by ingestion of larval cysts of the cestode Taenia solium (cysticercus cellulose) (CDC - Cysticercosis)
  • Acquired by swallowing food, water or feces contaminated by T. solium eggs
  • In cystecicercosis, the human represents an intermediate host, and the parasite develops cysticerci in various organs

  • Taeniasis: infection caused by the adult tapeworm in the human intestine, which occurs from ingestion of larvae in undercooked pork
  • Cysticerci: larval forms of tapeworms found within a fluid filled cyst
Epidemiology
  • 50 - 100 million people infected worldwide (eMedicine - Cysticercosis)

  • Endemic areas include: Central and South America, India, China Southeast Asia, Africa and Eastern Europe

  • In the United States, infection is most common in rural areas and among Latin American immigrants
Sites
  • Cysticerci develop in the nervous system, heart, skeletal muscle, eyes and subcutaneous tissue
Diagrams / tables
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Life cycle

Etiology
  • Accidental ingestion of eggs or gravid proglottids of Taenia solium by human host via infected food, water or feces
Clinical features
  • Cysticercosis of the skin is rare
  • It presents as a palpable, subcutaneous nodule
Diagnosis
  • Thorough history, skin biopsy, serology (serum or CSF) and imaging can aid in the proper diagnosis
Radiology description
  • CT scan can reveal hyperdense lesions in subcutaneous tissue with or without calcification
  • Ultrasound can reveal cystic lesions
Case reports
Treatment
  • Praziquantel and albendazole are effective
  • Surgery is appropriate for large, solitary lesions which would otherwise require prolonged antiparasitic therapy
Clinical images

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Computed tomography

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Gigantic cysticercosis pseudo tumour

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Swelling over neck

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Swellings over back

Gross description
  • Circumscribed, white to tan, cystic nodules containing a clear fluid
  • Cyst sizes vary, but commonly 1mm - 2cm
  • Larval forms identified within the cyst cavity
Gross images

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Cysticercosis pseudo tumor

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Well circumscribed nodule

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Specimen from trunk

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Various images

Microscopic (histologic) description
  • The cystic cavity contains the the larval form: scolex with hooklets and two pairs of suckers
  • The larval form, composed of duct-like invaginations, is lined by a double layered, eosinophilic membrane
  • Its body wall exhibits a myxoid matrix and calcareous bodies (calcified concretions)
  • Birefringent hooklets may be identified
  • Variable granulomatous reaction, inflammatory infiltrate with lymphocytes and eosinophils, fibrosis and calcification
Microscopic (histologic) images

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Contributed by: Dr. Thiriveni Balajji and Dr. M. Kavitha, Coimbatore Medical College (India)

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Cystic nodule, hip

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White mural nodule

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Fibrosis and inflammation

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Hooklet of cysticercus

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Parasitic granuloma

Cytology description
  • Fibrillary stroma with interspersed nuclei and a honeycomb pattern
  • Mixed inflammatory infiltrate