Fine needle aspiration cytologic diagnosis of toxoplasma lymphadenitis. A case report with detection of a Toxoplasma bradycyst in a Papanicolaou-stained smear.
BACKGROUND
Fine needle aspiration (FNA) cytologic diagnosis of toxoplasmic lymphadenitis with demonstration of a tissue cyst containing bradyzoites has been very rarely reported.


METHODS
A 17-year-old female presented with a mobile, painless, 2-cm-diameter swelling over the right suprascapular area. Clinical diagnosis was lipoma. FNA smears showed features of reactive lymphoid hyperplasia, including tingible body macrophages and groups of epithelioid histiocytes. A Toxoplasma cyst with bradyzoites was also demonstrated in a Papanicolaou-stained smear. Following FNA cytodiagnosis, serologic tests revealed a high titer of IgG and the presence of IgM-specific antibodies to Toxoplasma gondii, indicating active/recent disease.


CONCLUSIONS
FNA cytology is a valuable tool for the diagnosis of toxoplasmic lymphadenitis. Papanicolaou stain is appropriate for demonstration of the parasite. Serology is an excellent adjunct in clinching the diagnosis.
Pathan
Shahed K
SK
Cytopathology Unit, Mubarak Al-Kabeer Hospital, Kuwait.
Francis
Issam M
IM
Das
Dilip K
DK
Mallik
Mrinmay K
MK
Sheikh
Zafar A
ZA
Hira
Parsotam R
PR
D000293:Adolescent; D000818:Animals; D000906:Antibodies / Q000097:blood; D001707:Biopsy, Needle; D003560:Cysts / Q000469:parasitology / Q000473:pathology*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008067:Lipoma / Q000473:pathology; D008198:Lymph Nodes / Q000469:parasitology / Q000473:pathology*; D008199:Lymphadenitis / Q000097:blood / Q000469:parasitology / Q000473:pathology*; D012782:Shoulder / Q000469:parasitology / Q000473:pathology; D014122:Toxoplasma / Q000276:immunology / Q000472:pathogenicity; D014123:Toxoplasmosis / Q000097:blood / Q000150:complications*
D000906:Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M