Neurocysticercosis as Solitary Parenchymal Lesion Confirmed by Mitochondrial Deoxyribonucleic Acid Sequence Analysis-Case Report-

Ishikawa, Eiichi; Komatsu, Yoji; Kikuchi, Kazunori; Yamasaki, Hiroshi; Kimurâ, Hiroshi; Osuka, Satoru; Tsurubuchi, Takao; Itō, Akira; Matsumura, Akira

doi:10.2176/nmc.47.40

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…17 New diagnostic techniques in this field, such as mitochondrial DNA analysis, seem promising. 18 Current strategies for diagnosis of NCC include neuroimaging studies, 1 because a wide variety of neurologic syndromes can be associated with the disease. MR imaging findings are protean, depending on the stage of evolution of the larvae and on the fact that a single patient can present lesions in different stages of the disease simultaneously.…”

Section: Discussionmentioning

confidence: 99%

The Role of Conventional MR Imaging Sequences in the Evaluation of Neurocysticercosis: Impact on Characterization of the Scolex and Lesion Burden

Lucato

Guedes²,

Sato³

et al. 2007

American Journal of Neuroradiology

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Section: Discussionmentioning

confidence: 99%

The Role of Conventional MR Imaging Sequences in the Evaluation of Neurocysticercosis: Impact on Characterization of the Scolex and Lesion Burden

Lucato

Guedes²,

Sato³

et al. 2007

American Journal of Neuroradiology

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“…Phased degeneration into granuloma, fibrous scar and calcification without their specific structures like suckers and hooklets are followed as in our case 16. Because the foreign body granuloma of degenerating NCC could show tuberculoma-like lesions as demonstrated here or various non-characteristic morphologies, serology before treatment and monitoring of progression and mtDNA analysis using histopathological specimens are crucial tools for definitive diagnosis after surgery 2 9–11. Nonetheless, serology before treatment is the essential for diagnosis of NCC as it is well recognised in developed countries outside of Japan.…”

Section: Discussionmentioning

confidence: 79%

“…It is not always easy that the infectious diseases including atypical NCC are confirmed with the surgical specimens of the brain in non-endemic countries. However, molecular diagnosis using PCR has been introduced and established for molecular diagnosis of many pathogens and provided satisfactory results in NCC as well 8–11…”

Section: Introductionmentioning

confidence: 99%

Neurocysticercosis case with tuberculoma-like epithelioid granuloma strongly suspected by serology and confirmed by mitochondrial DNA

Maeda

Itō²,

Sako³

et al. 2011

Case Reports

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BACKGROUND Neurocysticercosis (NCC), caused by the larval stage ofTaenia solium ( T solium ), is the most common and serious parasitic disease of the central nervous system (CNS) in the majority of developing countries where people eat pork. 1 2 Clinical manifestations of NCC are highly variable depending on the number, type, size, localisation and developmental stage of cysticerci with the host immune response. 3 NCC, echinococcosis, anthrax and rabies are now recognised as re-emerging, but neglected, infectious diseases worldwide. 2 4 If NCC is suspected through neuroimaging, either typical or atypical, and questionnaire on visiting and/or living history in endemic areas of T solium , it is strongly recommended to carry out serology using highly specifi c antigens. 2 5 -7 NCC cases with multiple cysts are rather easily detectable by such a serology. 2 However, even highly specifi c serology is not always 100% sensitive especially in cases with solitary cyst, with calcifi ed cysts only or with background of immunodefi ciency. 2 Without typical neuroimaging or serological confi rmation of NCC, patients are often reluctantly treated surgically with suspected diagnosis of malignant tumours, tuberculosis or any other diseases causing neurological disorders especially in non-endemic countries. 2 Therefore, pathological approaches on NCC cases could inevitably become feasible for crucial diagnosis to identify such NCC cases. It is not always easy that the infectious diseases including atypical NCC are confi rmed with the surgical specimens of the brain in non-endemic countries. However, molecular diagnosis using PCR has been introduced and established for molecular diagnosis of many pathogens and provided satisfactory results in NCC as well. 8 -11 CASE PRESENTATIONAn Indian woman was referred to our hospital for the evaluation of multiple and nodular cerebral lesions. Two months before admission to our hospital, she noted occasional headache and paraesthesia of right forearm and MRI, examined in a local hospital, revealed Gd-well enhanced multiple nodular lesions with peripheral oedema and scattered calcifi cations ( fi gure 1 ). Because no neoplastic lesions could be excluded on the basis of these radiological fi ndings and because NCC is not indigenous in Japan 1 2 and most of clinicians have no or poor knowledge on NCC without their own experiences, NCC unfortunately was not suspected as a causative disease, and a brain biopsy was performed in a local hospital. However, fi gure 2 strongly suggested somewhat typical image of NCC with oedema, and if the clinicians tried to get second opinions from parasitologists, chemotherapy without neurosurgery could strongly be recommended with sound serological evidence. 1 2 6 12 The H&E-stained microsections derived from one of the cerebral nodules showed presence of epithelioid granulomas surrounded by reactive gliosis ( fi gure 3A ). These granulomas were also divided into three layers including plasma cell-rich mononuclear cell outer layer (mo), epithelioid-cell middl...

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“…The pathophysiology is not known but it is likely due to inflammatory response to residual parasite antigens. Because calcifications are the most common neuroimaging finding of parenchymal brain NCC and they accumulate, the small proportion that present in this fashion represent a large number of individuals [29,32,40,46,52,70]. …”

Section: Discussionmentioning

confidence: 99%

Cysticerci-related single parenchymal brain enhancing lesions in non-endemic countries

Brutto

Nash

Garcı́a

2012

Journal of the Neurological Sciences

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Objective Review of case reports and case series of patients with single cysticercus granulomas in non-endemic countries to determine the characteristics of this form of neurocysticercosis in these regions. Methods MEDLINE and manual search of patients with single cysticercus granulomas diagnosed in non-endemic countries from 1991 to 2011. Abstracted data included: demographic profile, clinical manifestations, form of neurocysticercosis, and whether the disease occurred in immigrants, international travelers, or citizens from non-endemic countries who had never been abroad. Results A total of 77 patients were found. Of these, 61 (79%) were diagnosed since the year 2000. Thirty-four patients (44%) patients were immigrants from endemic countries, 18 (23%) were international travelers returning from disease-endemic areas, and the remaining 25 (33%) were citizens from non-endemic countries who had never been abroad. Most immigrants and international travelers became symptomatic two or more years after returning home. Countries with the most reported patients were Kuwait (n=18), UK (n=11), Australia (n=8), USA (n=7), Japan (n=6), and Israel (n=5). Conclusions A single cerebral cysticercus granuloma in a non-endemic country is not a rare event. As seen in endemic regions, these cases have a good prognosis although more surgical procedures are performed in non-endemic countries, likely reflecting a decrease of diagnostic suspicion for cysticercosis and an increased availability of surgical options. The mean age of the reported cases was 25 years, and immigrants most often developed the disease greater than two years after arrival into a non-endemic area, suggesting a significant delay between infection and symptoms. However, some may have been infected and developed the disease while residing in non-endemic countries.

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Neurocysticercosis as Solitary Parenchymal Lesion Confirmed by Mitochondrial Deoxyribonucleic Acid Sequence Analysis-Case Report-

Cited by 10 publications

References 12 publications

The Role of Conventional MR Imaging Sequences in the Evaluation of Neurocysticercosis: Impact on Characterization of the Scolex and Lesion Burden

The Role of Conventional MR Imaging Sequences in the Evaluation of Neurocysticercosis: Impact on Characterization of the Scolex and Lesion Burden

Neurocysticercosis case with tuberculoma-like epithelioid granuloma strongly suspected by serology and confirmed by mitochondrial DNA

Cysticerci-related single parenchymal brain enhancing lesions in non-endemic countries

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