Diagnosis of Schistosomiasis japonica infection coincident with hepatocellular carcinoma by fine-needle aspiration.

Schistosomiasis japonica is not an endemic parasite in Taiwan. Previously, there have been no primarily infected cases reported with the exception of Chinese war veterans who had immigrated from Mainland China. We reported a 79-year-old patient who was diagnosed as having non-B, non-C liver cirrhosis complicated with a 1.2 x 1.2 x 1.2 cm liver tumor in the S5 of the liver. For a definitive diagnosis, we performed ultrasonographic-guided fine needle (21 gauge) aspiration biopsy. In the smear of liver aspiration, a calcified fragment of a parasite egg with foreign body reaction adjacent to the crowding cancer cells of hepatocellular carcinoma was found. To our knowledge, parasite eggs are difficult to find within the fibrotic bands using fine needle aspiration biopsy. The etiologic relationship between Schistosomiasis japonica infection and the hepatocellular carcinoma is also discussed in this report.