Fine Needle Aspiration Cytology of Hepatic Hydatid Cyst: A Case Study
A 28-year-old man presented with abdominal pain that had persisted for the past three months. The patient was a foreign worker from Uzbekistan. Physical examination revealed no abdominal mass. He had undergone partial hepatic resection due to a hydatid cyst 14 years ago. Abdominal computed tomography scan revealed a cystic mass in the right hepatic lobe (). Serologic testing for hydatid cysts was not performed. However, the clinical impression was a hydatid cyst. A right hemihepatectomy was performed, and the resected specimen was sent for intraoperative consultation. FNAC of the cystic mass was performed. The aspirated fluid was clear. Both smears and a cell block preparation were carried out. The smears were stained using Papanicolaou and hematoxylin and eosin stains.\nThe smears showed many protoscolices in the shape of a mushroom, with hooklets (). Amorphous necrotic debris and inflammatory cells were present in the background. Degenerated protoscolices were also found. Detached hooklets with refractile structures were seen. Fragments of laminated membranes stained pinkish-red on hematoxylin-eosin stain. Therefore, the diagnosis of a hydatid cyst was made.\nOn gross examination, the right hemihepatectomy specimen measured 15.3×14.8×8.5 cm in size. A 6.5×5.0×4.5 cm hepatic cyst was present (). The cyst contained multiple daughter cysts of variable sizes. The wall of the cyst was grayish white. Histologic examination revealed that the cyst wall was composed of an outer laminated membrane and an inner germinal layer (). Protoscolices and a brood capsule were seen. The laminated membrane was acellular and the germinal layer contained nuclei. The surrounding liver parenchyma showed a fibrinous wall and inflammatory cells infiltration including lymphocytes, eosinophils, and histiocytes. The patient has been alive for 16 months following this surgery without evidence of recurrence.