We present a case of hydatid disease and conclude that in a patient with a presumptive diagnosis of cystic hydatid disease, FNA is the primary method of confirming hydatid disease. Case Report A 40-year-old female complained of dull pain abdomen for the last 3 months. On per abdominal examination, no mass was palpable. Her routine hematological and biochemical investigations were within normal limits. Ultrasound abdomen revealed a 6x3.5 cm, unilocular hyperechoic lesion in right lobe of the liver. A radiological diagnosis of abscess liver was made. Hydatid serology was negative. Ultrasound guided fine needle aspiration (FNA) was done with 22gauge lumbar puncture needle and 110ml turbid fluid was aspirated. No untoward allergic reaction was observed following FNA .The fluid was centrifuged and smears were prepared from the sediment. The smears were stained by May-Grünwald Giemsa (MGG), haematoxylin & eosin (H&E) and Masson’s trichrome (MT) stains. Microscopic examination revealed numerous hooklets, laminated membrane and scolices. No inflammatory cells were seen. The laminated membrane appeared as fragments of acellular material with delicate parallel striations staining deep blue (Figure1). Many scolices which were round to oval structures about 100μm in diameter with one or two rows of characteristic radially arranged hooklets were seen (Figure 2). The hooklets were about 20-40um in size, semi-translucent, refractile, triangular or sickle-shaped with an inner semi-translucent core of the same shape. The hooklets were better highlighted by MT stain (Figure 2; Inset). Some scolices showed flame cells and were without hooklets (Figure 3). With these cytological findings, a diagnosis of hydatid cyst was made.
展开▼
