Case Study: FNAC: A safe procedure for the diagnosis of hydatid cyst


Hydatid cyst disease, also known as Echinococcosis, is a zoonotic infection that can affect any organ and tissue but is most often found in the liver or lungs. It is most common in rural areas, where patients have close contact with cattle [1]. Cases are generally asymptomatic and there is nearly always a delay in the diagnosis. An asymptomatic cyst or incidental findings in ultrasonography (USG) are common presentations of the disease. Here I shall describe 20 cases of hydatid cysts of multiple organs that were diagnosed by FNAC. There were no complications, and all of these cases were confirmed by histopathology after radical surgery. All but one patient recovered completely.


Hydatid disease occurs often in India, and is usually caused by larvae of the tapeworm Echinococcus granulosus. The cysts caused by the parasite may appear in nearly any organ, though generally in only one organ at a time. The liver is most commonly involved, and the lungs are involved in 10-30% of cases [2]. USG and CT-scan successfully pick up the entity in the majority of cases, but sometimes they are not able to rule out other possibilities [3, 4]. Complications like rupture with anaphylaxis, neurocerebral symptoms, recurrent infections and digestive problems may occur [5, 6]. So searching with various approaches (imaging, FNAC, serology, etc.) has always been there to confirm the diagnosis before surgery or albendazole-based chemotherapy or steroids. It might be best to avoid aspiration in hydatid disease, since some patients may have allergic reactions, or the disease could be spread further [7], but neither of these problems occurred in these cases studied by me. Previously, in a similar case study series, incidental aspiration of thoracichydatid cyst proved to be safe [7]. As a quick and reliable diagnostic test, FNAC is being practiced widely to diagnose hydatid cyst.

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