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Toxoplasmosis is caused by an obligate intracellular protozoan, Toxoplasma gondii, which can infect birds and mammals including humans. The disease is common throughout the world, and the most common clinical form is generalized or localized lymphadenopathy. However, in the literature, toxoplasmosis manifesting as a parotid mass is extremely rare. A 37-year-old female was admitted to our department with a painless mass in the parotid region, which had been present for one month. Upon physical examination, a hard, mobile, superficially located, and painless parotid mass with a size of 2x2 cm was detected. Following the diagnosis of a parotid neoplasm, a superficial parotidectomy was performed. Histopathological examination of the surgical specimen supported a diagnosis of toxoplasmosis lymphadenitis. Specific serum immunoglobulin levels were studied and results also confirmed the diagnosis of toxoplasmosis. The patient was given rovamycine for three weeks, and on 12 months follow-up, the patient was still free of recurrence.

Objective: To define the cytomorphologic features of toxoplasmic lymphadenitis (TL) and to establish the diagnostic sensitivity and specificity of the cytologic diagnosis., Study Design: A cytohistologic correlation study of 11 patients in which a histologic diagnosis of TL was available. These cases were analyzed in a blind study among other cases of nonneoplastic lymphadenopathies. The results of the study are expressed in terms of diagnostic sensitivity and specificity. Although not included in the study, 3 other cases of TL with serologic confirmation were also reviewed., Results: Microgranulomas were a characteristic finding in TL. They consisted of small clusters of epithelioid histiocytes, each with abundant cytoplasm and an eccentric, oval nucleus. Diff-Quik-stained smears had cytoplasm with particularly pale staining and a homogeneous appearance. Most microgranulomas had a monotonous appearance with a few, small lymphocytes accompanying the epithelioid cells. No necrosis, suppurative changes or giant cells were present. Blind examination by 4 reviewers led to a correct diagnosis of TL in 9 of the 11 cases. Eight of the 9 cases were recognized by each of the 4 reviewers. One false positive diagnosis was made by 1 of the reviewers. The sensitivity of the diagnosis was 72.7-81.8% and the specificity 98.8-100%., Conclusion: This study showed high sensitivity and specificity for the cytologic diagnosis of TL. Given the appropriate clinical context, the presence of characteristic epithelioid microgranulomas permits a diagnosis of TL. The cytologic diagnosis can be easily confirmed with serologic studies, thereby avoiding biopsy.

Objectives: To investigate the incidence of toxoplasmosis in patients with lymphoid hyperplasia of the head and neck., Patients and Methods: In this study, 53 patients (32 males, 21 females; mean age 11.2+/-4.3 years, range 5 to 22) were investigated. There were hypertrophic tonsillitis in 13 patients, hypertrophic tonsillitis and adenoid hyperplasia in 22 patients, adenoid hyperplasia in 10 patients, and lymphadenopathy of the neck in eight patients. In venous blood samples, IgM and IgG antibodies for Toxoplasma gondii were investigated with the enzyme-linked immunoabsorbent assay (Axsym, Abbott)., Results: Positive IgG was determined in 23 patients (48%) with hypertrophic tonsillitis (n=6), hypertrophic tonsillitis and adenoid hyperplasia (n=10), adenoid hyperplasia (n=3), and lymphadenopathy of the neck (n=4). Positive IgM was determined in 5 patients (9.4%) with hypertrophic tonsillitis (n=1), hypertrophic tonsillitis and adenoid hyperplasia (n=1), and lymphadenopathy of the neck (n=3)., Conclusion: Toxoplasmosis, which is known to cause lymphadenopathy, may be a reason for lymphadenopathy of the neck. Toxoplasmosis should be considered in the differential diagnosis of untreated patients with tonsillitis, adenoid hyperplasia, and chronic neck lymphadenopathy.

Two siblings residing on a farm in Illinois were concurrently hospitalized with cervical lymphadenitis. Clinical and serologic evidence indicated that the etiology of the lymphadenitis in each case was toxoplasmosis. The simultaneous occurrence of two cases of toxoplasmosis in a household prompted a prospective investigation of 11 other immediate family members for evidence of disease. During the next month seven of the other family members developed serologic evidence of acute toxoplasmosis. Four of these seven individuals were symptomatic. Investigation of the family's home environment failed to unequivocally identify a common source of infection, but epidemiologic evidence suggested that this outbreak was related to contact with sick cats.

Two cases of cervical adenopathy are described. One manifested as lymphoma clinically. Both patients were found to have primary lymph node leishmaniasis without cutaneous, mucosal or visceral involvement. The histologic appearance simulated toxoplasma lymphadenitis. Electron microscopic study differentiated the organism from Toxoplasma, and the condition responded well to antimony therapy.

The diagnosis of toxoplasmic lymphadenitis was established through the demonstration, by direct immunofluorescence, of toxoplasma cysts and trophozoites in a cervical lymph node biopsy which also had a characteristic histopathology. The patient had cervical lymphadenopathy and increased specific fluorescent antitoxoplasma IgG and IgM antibodies.

Even simple lymphadenitis during pregnancy may possibly be an acquired lymphatic form of toxoplasmosis with all detrimental consequences to the foetus.

In the course of evaluating the fine-needle aspiration technic a toxoplasma cyst was identified in a lymph node excised from a patient in whom toxoplasmosis subsequently was confirmed serologically. This is the first reported case in which a cyst was identified by this method. The recognition of a cyst and characteristic cytologic features in the aspirate demonstrates the utility of fine-needle cytologic examination in diagnosing toxoplasmic lymphadenitis.

Lymphadenopathy is the most frequent clinical manifestation of acute acquired infection with Toxoplasma in the immunocompetent individual. One hundred seven cases of histologically verified toxoplasmic lymphadenitis were reviewed in an effort to determine the usual modes of clinical presentation and the incidence of extranodal disease. Toxoplasmic lymphadenitis most frequently involved a solitary lymph node in the head and neck regions, without systemic symptoms or extranodal disease and with a benign clinical course. However, serious extranodal disease did occur in some patients and included myocarditis, pneumonitis, encephalitis, chorioretinitis, and transmission of the infection to the fetus. Case histories are presented to illustrate important points with respect to clinical presentation, complications, and diagnosis.

In this article, point of views about toxoplasmosis lymphadenopathy had been summarized and it's different properties had also been explained.

The clinical symptoms of toxoplasmosis in man are very various and often uncharacteristical. Until now there are no statistical evaluations on the frequency of different clinical appearances of the disease. A comparison of the clinical symptoms and the results of serology was made on 14 618 patients with suspected toxoplasmosis, who were divided into groups in regard to their age and clinical symptoms. Suggestions for the diagnosis of toxoplasmosis are given by this evaluation.

The diagnostic protocol for lymph node toxoplasmosis presented in this study is based on the following sequence: 1. specific serologic tests (IHAT, IFAT, IgM-IFAT) on total serum and on purified IgM serum fraction, performed twice, within a time interval of 21-28 days; 2. Lymph node biopsy for histologic studies and for isolation of the parasite in mice (biologic test). A critical analysis is reported for 20 cases submitted to this protocol in the course of the year 1980.

Serum antitoxoplasma titres were determined simultaneously by the direct agglutination and the indirect immunofluorescent tests in 52 children aged 2 to 16 years having chronic lymph node enlargement, mainly cervical. Direct agglutination titres were raised (64 to 4096) in 22 children (42%), but rarely in the control groups of children with acute suppurative lymphadenitis, and healthy children, adults, nurses, and physicians. It is concluded that toxoplasmosis is commoner in Greek children than previously believed, and that it should be included in the differential diagnosis of lymphoglandular enlargement. Clinically the condition is mild and may be self-limited, but it should be treated promptly with trimethoprim-sulphamethoxazole, in order to prevent reactivation in adult life.

Posterior cervical node enlargement is characteristic of clinical toxoplasmosis in adults. Lymph node biopsies from 37 patients, who were tested for toxoplasmosis by serologic and isolation studies, were examined. A characteristic pattern of sinus histiocytosis was seen in 17 of 18 posterior cervical nodes and in only 1 of 4 lymph nodes from other sites from patients with toxoplasmosis. The characteristic pattern was not seen in posterior cervical nodes or in lymph nodes from other sites from patients with other diseases. Lymphoma obscured the characteristic changes of toxoplasmosis in the posterior cervical nodes and other nodes of 5 patients with these coexisting diseases. Organisms were seen in tissue sections in only 2 instances. T gondii was isolated from mice in 14 of 17 attempts using nodes from patients with toxoplasmosis, but from none of 8 attempts using nodes from patients with other diseases.