Fine needle aspiration biopsy (FNAB) was performed in 31 patients with
hydatid disease by 15 operators in 41 biopsy events during the period
1983-93. The FNABs were unintentionally done without prior clinical s
uspicion of hydatid cysts (HCs) in 18 patients and intentionally (with
prior clinical suspicion of HC) in 13 patients for pathologic confirm
ation required for specific therapy. The FNABs were performed with the
guidance of fluoroscopy (n=7), CT (n=14) or ultrasonography (n=10). T
he material included both closed, open and ruptured HCs from different
locations such as abdomen, thorax, spine and bone. Pathologic confirm
ation of HC was achieved by recovering and demonstrating parasitic mat
erial in the specimen. In only 7 of 31 patients were the specimens dia
gnostic at the initial interpretation. This emphasizes the importance
of alerting the pathologist about the possibility of hydatid disease.
In 25 of 31 patients (81%) no biopsy reactions occurred. In 5 patients
minor allergic reactions occurred and 3 had filling of air into intra
thoracic cysts not requiring therapy. One patient, with a FNAB of a li
ver HC, had a sudden severe drop in blood pressure, which required ant
i-shock therapy with subsequent recovery without sequelae. All complic
ations occurred with non-intentional biopsy of HC. Suggestions for dia
gnostic and therapeutic management of patients with HC and advice to a
void or limit potential complications or spread of disease are given w
here a planned biopsy is necessary for appropriate and effective thera
py.