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Leishman stain in detection of hydatid hooklets in liver space occupying lesions

Niranjan Rout, Manorama Swain, Sashibhusan Dash, Omprakash Agarwal, Chudamani Meher, Shivaram Prasad Singh.


Background: Hydatid disease (HD) is endemic in India. Human beings are usually infected as intermediate host when they ingest contaminated food or water by the egg of Echinococcus granulosus. HD usually presents as cysts in various organs of the body. Often the disease presents as solid lesions in liver and ultrasonographically confused with hepatic tumors. These solid lesions can be easily diagnosed by ultrasound guided fine needle aspiration cytology (FNAC) with a demonstration of the presence of hooklets of hydatid.

Objective: To study the utility of Leishman stain for detection of hydatid hooklets.

Materials and Methods: Ultrasonographically (USG) diagnosed 340 patients with liver SOL were included in the study. Ultrasound guided FNAC was done and smears from the aspirate were stained with Papanicolaou (Pap), hematoxylin-eosin (HE) and Leishman Stain.

Results: Out of 340 patients with hepatic SOL subjected to USG-FNAC six cases were diagnosed as HD. Aspirates were stained with Pap, HE, and Leishman stain. Identification of hooklets was regarded as pathognomonic. The hooklets were not clearly visible under lower magnification, and the typical glistening hooklets were visible under high power objective with Pap and HE stained smears, whereas in Leishman stained smears the hooklets were clearly identified under both low power and high power objective.

Conclusion: Leishman stain, a common stain of all laboratories, is a useful stain for cytodiagnosis and can be used successfully to detect the hooklets of hydatid under the microscope.

Key words: Hydatid Disease; Hooklets; Leishman Stain

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