Case #154 – April, 2005

A 49-year-old male immigrant from Mexico was seen at a local medical facility specializing in neural disorders for frequent headaches and occasional seizures. Figures A and B show what was observed on a hematoxylin and eosin (H & E) stained section of lesions detected in the right frontal lobe of his brain. Figure A was taken at 40× magnification and Figure B was taken at 100× magnification. What is your diagnosis? Based on what criteria?

Figure A

Figure B

This was a case of cysticercosis caused by the larval stage of Taenia solium. Diagnostic features were:

a single protoscolex (yellow circle, Figure A) visible within the bladder wall (blue arrows, Figure A). Racemose cysticerci are characterized by proliferating, lobulated cysts without a scolex which are usually found in the ventricular system and subarachnoid space, and, rarely, in the cerebral parenchyma.
the extensive folding of the spiral canal and one sucker of the protoscolex (black arrow, Figure B).
the presence of calcareous corpuscles (green arrows, Figure B).

Figure A

Figure B

Serology for cysticercosis is recommended as a noninvasive laboratory diagnostic procedure prior to treatment that can be very useful in patients suspected of having cysticercosis.