Primary hydatid cyst of the supraspinatus muscle: Complete removal of the germinal layer and cytodiagnosis by fine‐needle aspiration

Primary hydatid disease of the skeletal muscle without systemic involvement is rare. The purpose of this report is to document the novel clinical presentation and the interesting facets of fine‐needle aspiration in a case of hydatid disease. It was a case of primary hydatid cyst of the left supraspinatus muscle in an Indian woman living in Kuwait, which was clinically diagnosed as a lipoma. Fine‐needle aspiration (FNA) yielded 2 ml of clear fluid with white particulate material. The cytocentrifuged smears prepared from the aspirated fluid showed many scolices, occasional laminated cyst wall fragments and numerous hooklets. The laminated cyst wall and scolices were PAS positive. Trichrome staining imparted a demon‐head‐like appearance to the scolices. The cytodiagnosis of hydatid cyst was corroborated by histopathological examination of an excised whitish membrane and an irregular cystic fragment, which showed parallel laminations without germinal layer, and skeletal muscle with granulomas and a dense eosinophilic infiltration, respectively. Quantitative serological (indirect hemagglutination) test on blood sample collected 9 days after the excision of the cyst showed insignificant antibody titer to Echinococcus sp. and after 6 weeks the antibodies were completely absent. CT scan of the chest and abdomen performed 7 weeks after removal of cyst showed no evidence of visceral hydatid cyst. Diagn. Cytopathol. 2014;42:268–272. © 2012 Wiley Periodicals, Inc.     

First Successful Puncture, Aspiration, Injection, and Re-Aspiration of Hydatid Cyst in the Liver Presenting with Anaphylactic Shock in Korea

Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst.     

Les complications pariétales du kyste hydatique du foie. à propos de deux cas en Tunisie

The aim of this study is to consider the parietal complications of the hydatid cyst of the liver: the subcutaneous rupture of the cyst and spontaneous cutaneous fistula of liver hydatid cyst. 1^st case: A 24-year-old woman, who underwent surgery 10 years ago for hydatid cyst of the liver, was admitted for a right hypochondrium mass and a fistula draining clear liquid containing cystic elements. Computed tomography (CT) showed a large cystic lesion in the subcutaneous tissue communicating with another cystic mass in the liver. The diagnosis of a cyst-cutaneous fistula due to a peritoneal hydatid cyst was established. The patient underwent surgical treatment and recovered uneventfully. 2^nd case: A 40-year-old woman presented with a mass in her right hypochondrium. The diagnosis of subcutaneous rupture of a hydatid cyst of liver was established by ultrasonography and CT-scan. The patient underwent surgical treatment and recovered uneventfully. Parietal complications of hydatid cyst of the liver are extremely rare, clinical presentation can be derailing. The diagnosis is usually established by ultrasonography and CT-scan.     

Comparative study of cattle, sheep and goats on biochemical profiles of hydatid cyst fluid from the lungs and liver

Hydatid cysts are one of the most prevalent zoonotic diseases and cause major economic and health problems around the world. The aim of this study was to evaluate and compare the biochemical profiles of hydatid cyst fluid obtained from the lungs and liver of cattle, sheep and goats naturally infected with Echinococcus granulosus. In each species, 11 biochemical profiles of hydatid cyst fluid (calcium, sodium, potassium, magnesium, glucose, urea, uric acid, cholesterol, triglyceride, creatinine and total protein) were determined and compared between the lung and the liver. No significant differences in biochemical profiles were observed in cattle, sheep or goats (P?>?0.05) indicating that biochemical profiles of hydatid cyst fluids do not relate to cyst location.     

Intraoperative diagnosis of hydatid cyst of the ovary masquerading as tumor

Hydatid disease, caused by the larval stage of Echinococcus granulosus, is found most commonly in the liver and lungs, but no organ is immune. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. Occasionally, the cyst enlarges, thus mimicking an ovarian tumor. Patients with hydatid cysts at unusual locations present with atypical presentations and pose a diagnostic dilemma. A high index of suspicion is required in order to make a correct diagnosis pre‐operatively to prevent spillage of the cyst contents during surgery. We report a case of hydatid cyst in the ovary in a young female. Diagn. Cytopathol. 2017;45:267–269. © 2016 Wiley Periodicals, Inc.     

Prevesical hydatid cyst: an exceptional occurrence

Echinococcal cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. We report a case of a prevesical hydatid cyst. A 53-year-old man was admitted with a large suprapubic mass. Ultrasonography and computed tomography revealed a cystic mass situated in front of the urinary bladder. There were no cysts in any other location. Serological tests were positive for Echinococcus. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of Echinococcosis. Isolated hydatid cyst situated in front of the urinary bladder has never been described in the literature. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions, before any procedure like puncture, biopsy or cystectomy, in order to avoid dissemination of the cystic contents or an anaphylactic shock.     

Serodiagnosis of sheep hydatidosis with hydatid fluid, protoscolex, and whole body of Echinococcus granulosus antigens

Diagnosis of hydatidosis is based on immunodiagnostic methods along with radiological and ultrasound examinations. A great number of immunological assays have been developed for detection of anti-hydatid cyst antibodies. The principal intermediate host of Echinococcus granulosus in most endemic regions of the world is sheep. Antibodies to various antigens are detectable in the sera of some, but not all infected sheep. The objective of the present study was to develop a specific and simple antigen-based ELISA method for diagnosis of hydatidosis in sheep with different (hydatid fluid, protoscolices, and whole body of E. granulosus) antigens. A total of 100 sera were collected from sheep with hydatidosis proven by inspection of hydatid-infested livers and lungs of the sheep slaughtered in Mashhad abattoir. Hydatid fluid and protoscolex were isolated from livers or lungs of sheep with hydatid cyst in sterile conditions. Whole body of E. granulosus was isolated from intestine of infected dogs. Sera samples were examined by ELISA with different antigens. The results of antibody detection by indirect ELISA, using different antigens, showed that the hydatid fluid was the most effective antigen of those assessed for detection of infection with hydatidosis in sheep. Findings of this study indicated that antibody detection assay is a sensitive approach for diagnosis of hydatid cyst in sheep.     

Immunological diagnosis of human cystic echinococcosis: utility of discriminant analysis applied to the enzyme-linked immunoelectrotransfer blot.

An enzyme-linked immunoelectrotransfer blot for the diagnosis of human hydatid disease was performed, and the different antibody responses were analyzed by a discriminant analysis. This multivariate technique gave us, first, a selection of the most important responses against Echinococcus granulosus infection and, second, a procedure for the classification of patients into two groups: patients with hydatid disease and patients without a history of hydatid disease. This method was applied to 67 patients, 25 with active hydatid cysts (24 hepatic and 1 pulmonary) and 42 without a history of hydatid disease and was compared with the results obtained by conventional serology: indirect hemagglutination, latex particle agglutination, and basophil degranulation. An immunoelectrotransfer blot coupled to a discriminant analysis was more sensitive than conventional serological diagnosis and detected 100% of patients with an active hepatic hydatid cyst with a specificity of 100%. This method, however, failed to detect an uncomplicated hyaline pulmonary hydatid cyst.     

Renal hydatid cyst: Urinary cytological diagnosis

Echinococcal disease is endemic in many areas of Asia, Europe, South America, the Near East, Australia, and New Zealand. Hepatic and pulmonary cysts are the most common presentation. Isolated renal hydatid cyst is an uncommon presentation of echinococcal disease, since renal involvement occurs in only 2–3% of cases. We present the case of a young man with renal colic, in whom the diagnosis of renal hydatid disease was established cytologically. Urine cytology, performed because of persistent hematuria, revealed scolices of Echinococcus granulosus and prompted further imaging investigation, and, ultimately, surgical treatment. © 1995 Wiley- Liss, Inc     

Echinococcus granulosus: occurrence of ecdysteroids in protoscoleces and hydatid cyst fluid

Both free ecdysteroids and hydrolysable polar conjugated ecdysteroids were detected in protoscoleces of Echinococcus granulosus from the equine host, and in hydatid cyst fluid from the same source. Comparisons were made of hydatid cyst fluid from E. granulosus infections of three intermediate host species: horses, sheep and humans. Ecdysone and 20-hydroxyecdysone were identified in both protoscoleces and hydatid cyst fluids by high-performance liquid chromatography monitoring fractions by radioimmunoassay, and by capillary gas chromatography/mass spectrometry (selected ion monitoring). The free ecdysteroid fractions of hydatid cyst fluid from horses and sheep also contained several unidentified, chromatographically unique, immunoreactive compounds which were refractory to hydrolysis with a crude Helix pomatia aryl sulphatase enzyme preparation.     

Comparative evaluation of enzyme-linked immunosorbent assay for the diagnosis of pulmonary echinococcosis.

An enzyme-linked immunosorbent assay was done for the detection of immunoglobulin G and M (IgG and IgM) antibodies to Echinococcus granulosus in surgically proved cases of hydatidosis, especially pulmonary hydatidosis, by use of human hydatid cyst fluid antigen and soluble scolex antigen. This assay was compared with the following standardized techniques: the indirect hemagglutination test, the indirect immunofluorescent antibody test, and Casoni's intradermal test. The enzyme-linked immunosorbent assay, with either of the antigens (human hydatid cyst fluid or soluble scolex antigen), was more sensitive and specific than the other techniques in diagnosing cases of hydatidosis, especially hydatid disease of the lung.     

Primary hydatidosis of gluteus maximus

Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by echinococcus granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Eggs are passed in feces and eaten by intermediate hosts and larvae encyst in the liver, lungs and other organs. Primary muscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. A case of intramuscular gluteal hydatid cyst is being reported with the intent of highlighting this atypical localization of the disease. Since the soft tissue tumors may be confused with hydatid cysts, preoperative evaluation of these patients is critical for proper handling during surgery to avoid life-threatening complications. We report a case of a 24-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on sonography and computerized scanning. Surgical excision with postoperative antihelmenthics formed the main modality of treatment.     

细粒棘球绦虫重组BCG-Eg95疫苗诱导的保护力观察

目的 探讨细粒棘球绦虫重组BCG-Eg95疫苗免疫鼠后对Eg原头节攻击感染的保护性作用.方法 '将细粒棘球绦虫重组BCG-Eg95疫苗采用皮下注射、鼻腔内接种、口服灌胃和肌肉注射4种途径分别免疫Balb/C鼠,免疫后8W用Eg 原头节进行攻击感染,感染后18周剖杀小鼠,计算减蚴率,测定血清中IgG及其亚类和IgE水平,同时设有BCG和PBS对照.结果 疫苗接种组的减蚴率为18.20%～92.46%,血清IgG、IgG2a、IgG2b水平明显升高,IgG1、IgG3和IgE显著降低.结论 细粒棘球绦虫重组BCG-Eg95疫苗口服灌胃和肌肉注射是两种较好的接种途径,IgG、IgG2a和IgG2b在疫苗诱导的保护力中起重要作用.     

Echinococcus granulosus: ultrastructural effect of albendazole therapy

The effects of the anthelmintic Albendazole against Echinococcus granulosus hydatid cysts in Turkana patients given orally were studied by means of ultrasound as well as light microscopy, scanning and transmission electron microscopy. The treatment generally reduced the size of the cyst mass, making the patients feel well. The drug therapy caused collapse of the cyst wall and daughter cyst. The pathological changes on the germinal layer of Albendazole-treatment cysts differed widely from the untreated control hydatid tissue. The effects included morphological changes of the protoscolices, presence of lamellated bodies, necrosis with detachment of the germinal layer from the laminated layer. However, some parts of the Albendazole-treated hydatid tissue remained unaffected.     

Intramedullary hydatid cyst of the cervical spine

Hydatid disease (Echinococcosis) is a common parasitic infection caused by Echinococcus granulosus mainly in sheep-raising areas of the world. Liver, lungs and brain are the predominantly involved organs. However, 0.5–1% of the hydatid disease involves the spine and in 90% of the cases it is confined to the bone and the epidural space. Although intramedullary involvement is extremely rare, in this report, we present a 55-year-old female patient who was diagnosed with a cervical intramedullary hydatid cyst during magnetic resonance imaging of the cervical vertebrae. Accordingly, we imply that particularly in endemic areas, hydatid cyst disease should be kept in mind for the differential diagnosis of spinal mass lesions.     

Purification of antigen for serodiagnosis of echinococcosis

Antigen for serodiagnosis of Echinococcosis is purified by chromatography on DEAE-Cellulose and Sephadex G-200 from hydatid cyst fluid. The antigen is electrophoretically pure and found sensitive and specific for Echinococcus granulosus. The antigen is thermostable and is apparently a lipo protein.     

The role of cattle in the epidemiology of Echinococcus granulosus in Kerman area, southeast of Iran

The study was carried out from September 2010 to September 2011 at Kerman Municipal abattoir to assess the status of hydatidosis in cattle. Out of the total 1,000 cattle examined visually and manually (palpation and incision), 86 (8.6%) were found harboring hydatid cysts. A significantly higher infection was detected in older cattle (P?<?0.05) than younger ones. Of the total of 86 infected, 13 (15.11%) had hydatid cysts only in the lung, 33 (38.37%) in the liver, 2 (2.32%) in the muscles, while the rest 38 (44.18%) had multiple organ infections. Of the 125 viscera harboring hydatid cysts, the highest (56.8%) was the liver followed by the lungs (40.8%) and the muscles (2.4%). From the total of 721 hydatid cysts counted, 205 (28.43%), 222 (30.79%), 45 (6.24%), and 249 (34.53%) were found to be small, medium, large, and calcified cysts, respectively. The distribution of characterized cysts in different organs based on their size was found to be statistically significant (P?<?0.05). In addition, out of the total 721 cysts collected, 5.40% were fertile, 60.05% sterile, and 34.53% calcified or purulent cysts. The rate of cyst calcification was higher in the liver than in the lung. There was a significant difference in the fertility of the cyst from different organs (P?<?0.05); fertility rate was higher among the cysts of the liver. Hydatid cyst viability rate of 61.53% was observed.     

Usefulness of Hydatid Cyst Fluid of Echinococcus granulosus Developed in Mice with Secondary Infection for Serodiagnosis of Cystic Echinococcosis in Humans

The aim of this work was to assess the usefulness of hydatid cyst fluid (HCF) of Echinococcus granulosus, obtained from mice experimentally infected with hydatid cyst tissue homogenates, for the serodiagnosis of cystic echinococcosis (CE) in humans. The sensitivity and specificity of HCF obtained from mice for the detection of immunoglobulin G (IgG) antibodies in the sera of CE patients were compared with those of HCF from sheep and/or from a human CE patient by using immunoblotting (IB) and an enzyme-linked immunosorbent assay (ELISA). HCFs obtained from three different host species all were highly useful for immunoblotting, and sera from 19 (95%) of 20 CE patients equally recognized the antigen B subunit (approximately 8 kDa). HCF from mice showed a cross-reaction with 9 of 20 alveolar echinococcosis (AE) sera (45%), whereas HCFs from two other host species cross-reacted with 14 of the AE sera (70%). Although 2 (10%) of 20 sera from neurocysticercosis (NCC) patients were false positive with HCF from both sheep and humans, none of these sera showed a positive reaction with HCF from mouse origin. ELISAs with HCFs from both mouse and sheep origins detected all 20 CE and AE sera; however, these ELISAs showed 45% (9 of 20) and 60% (12 of 20) false-positive reactions with 20 NCC sera, respectively. The presence of nonspecific human IgG in HCF obtained from a CE patient prevented us from applying it to the ELISA. HCF of E. granulosus, obtained from laboratory mice with a secondary infection with hydatid cyst tissue homogenates, appears to be highly useful for the serodiagnosis of CE in humans and may be useful in domestic animals.     

Pathological changes in the lymphoreticular tissues of swiss mice infected withEchinococcus granulosus cysts

Summary Swiss mice infected intraperitoneally with approximately 1,500 protoscolices ofEchinococcus granulosus and sacrificed at three and 13 months post infection yielded both viable and degenerated hydatid cysts. The mean cyst weights in the three and 13 months post infected mice were 0.13 and 2.1 g, respectively. Sections of spleens and lymph nodes in the three months post infected mice showed hyperplastic follicles and blastoid cells in thymus dependent areas. At 13 months post infection T cells from paracortex and periarterial areas were replaced by plasma cells and confluent sheets of histiocytes; follicles had retained germinal centres and medullary areas showed intense plasmacytosis and sinus histiocytosis. Failure of mice to control the histogenesis of hydatid cyst with reference to numerical reduction in T cells is discussed.     

Isolation and partial characterization of species-specific and cross-reactive antigens of Echinococcus granulosus cyst fluid

Two parasite antigens have been isolated from Echinococcus granulosus hydatid cyst fluid using hydrophobic interaction chromatography, anion exchange chromatography and gel filtration chromatography. Initial characterization of the antigens indicates that both are glycoproteins, of approximately 20 and 48 kDa (Eg20 and Eg48). When the two antigens were tested with a battery of antisera from patients with heterologous parasitic infections, only Eg20 was found to be specific for E. granulosus. The Eg48 antigen cross-reacted with the sera of 33% of E. multilocularis patients. In both antigens, some of the epitopes recognized by antibodies in the sera of hydatid patients were periodate-sensitive. This suggests the involvement of carbohydrates in at least some of the antigenic determinants. Due to the abundance of the Eg48 antigen in the hydatid cyst fluid, it would be the more practically useful antigen for disease diagnosis, especially in countries where only E. granulosus is endemic.