Anatomopathological aspects of neurocysticercosis in autopsied patients

Abstract

-The aim of this paper was to describe the occurrence and morphology of neurocysticercosis (NCC) in autopsies. We revised 2218 autopsies performed at the School Hospital from Federal Unversity of Triangulo Mineiro, 1970Mineiro, -2003. Data referring to age, gender and color of patients were reported and NCC was microscopically and macroscopically analyzed. We found 53 (2.4%) NCC cases. The mean age was 50 years old, 34 (64.1%) individuals were male and 36 (67.9%) white. Macroscopically, 17 cysticerci were analyzed. The most frequent location was meningocortical in 12 (70.6%) cases. Microscopically, the cysticerci presented an ovoid shape, containing the larvae preserved in 4 (23.5%) cases or in destruction degrees in 13 (76.5%) cases. Therefore, in NCC was found several general pathologic processes (necrosis, interstitial deposits, fibrosis, gliosis, inflammation) amongst which are highlighted beta-fibrillose in 13 (76.5%) cases associated to inflammatory process in 16 (94.1%) cases caused by the parasite, not yet related to NCC, and calcification present in viable and destruction parasites.KEY WORDS: autopsy neurocysticercosis, general pathologic processes, cysticercosis, central nervous system. Aspectos anatomopatológicos da neurocisticercose em pacientes autopsiadosRESUMO -O objetivo desse trabalho foi descrever ocorrência e morfologia da neurocisticercose (NCC) autópsias. Revisou-se 2218 autópsias realizadas no Hospital Escola da Universidade Federal do Triângulo Mineiro (UFTM), 1970-2003. Registrou-se idade, gênero e cor dos pacientes, analisou-se macroscopia e microscopia da NCC. Encontrou-se 53 (2,4%) casos de NCC. A média das idades foi 50 anos, sendo 34 (64,1%) do sexo masculino e 36 (67,9%) brancos, não havendo diferença significante na comparação da idade, gênero e cor dos pacientes. Analisou-se macroscopicamente 17 cisticercos. A localização mais comum foi a meningocortical em 12 (70,6%) casos. Microscopicamente, os cisticercos apresentaram forma oval contendo a larva íntegra em 4 (23,5%) casos ou em grau de destruição em 13 (76,5%) casos. Portanto, na NCC foram verificados vários processos patológicos gerais (necrose, depósitos intersticiais, fibrose, gliose, inflamação) destacando-se: beta-fibrilose em 13 (76,5%) casos associada ao processo inflamatório em 16(94,1%) casos causado pelo parasito, ainda não relatada na NCC, e calcificação presente no parasito viável e em destruição. PALAVRAS-CHAVE: autópsia, neurocisticercose, processos patológicos gerais, cisticercose, sistema nervoso central.Human cysticercosis occurs due to ingestion, with contaminated food, of eggs containing oncospheres. In the intestinal portion the oncospheres hatch, penetrate in the intestinal wall and disseminate through blood and lymph vessels until it gets to several tissues, however with great tropism to the central nervous system (CNS) 1,2 . Neurocysticercosis (NCC) is characterized by presenting several clinic manifestations 3 . The polymorphism of its clinic manifestations depends not only on its localization ...

Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis?

“…Both parasitic tissue and antibody titers might be absent if the parasitic lesions degenerated and involuted decades ago. An autopsy study demonstrated larval tissue in only 24% of cysticercosis lesions . Our literature search did not identify CAPNON‐like changes in studies of neurocysticercosis.…”

A Systematic Review of the Frequency of Neurocyticercosis with a Focus on People with Epilepsy

“…We identified four studies conducted in autopsied patients from large hospitals in Brazil and Mexico [7], [21]–[23]. These results were very similar, but three of the four studies were conducted in the same province of Brazil, thus representing the same population.…”

“…Four studies reported the proportion of NCC among people who were autopsied [7], [21]–[23]. The percentages were similar across the four studies, varying from 1.5% to 2.6%, with three of the four studies conducted in the same area of Brazil (Table 3).…”

“…Most studies reported the proportion of people with NCC among symptomatic target populations. Two studies from the United States of America reported the incidence rate of NCC based on hospital discharge data ([20], Thompson J, unpublished data), and four studies reported the proportion of NCC among people who were autopsied after death for any reason [7], [21]–[23]. In seven community-based studies, NCC was assessed among PWE or people with seizure disorders ([8], [24]–[28], Carabin et al, unpublished data).…”

Histological and molecular biology diagnosis of neurocysticercosis in a patient without history of travel to endemic areas – Case report

“…Because of its pleomorphic nature, NCC can be misdiagnosed (Garcia et al , 2003; Lino-Junior Rde et al , 2007). In this case, a tumor was initially suspected as the cyst was in a degenerative stage.…”