Malignant Transformation of Hymenolepis nana in a Human Host

N Engl J Med. 2015 Nov 5;373(19):1845-52. doi: 10.1056/NEJMoa1505892.


Neoplasms occur naturally in invertebrates but are not known to develop in tapeworms. We observed nests of monomorphic, undifferentiated cells in samples from lymph-node and lung biopsies in a man infected with the human immunodeficiency virus (HIV). The morphologic features and invasive behavior of the cells were characteristic of cancer, but their small size suggested a nonhuman origin. A polymerase-chain-reaction (PCR) assay targeting eukaryotes identified Hymenolepis nana DNA. Although the cells were unrecognizable as tapeworm tissue, immunohistochemical staining and probe hybridization labeled the cells in situ. Comparative deep sequencing identified H. nana structural genomic variants that are compatible with mutations described in cancer. Invasion of human tissue by abnormal, proliferating, genetically altered tapeworm cells is a novel disease mechanism that links infection and cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Animals
  • Cell Transformation, Neoplastic*
  • DNA Mutational Analysis
  • DNA, Helminth / isolation & purification
  • Humans
  • Hymenolepiasis / pathology*
  • Hymenolepis nana / cytology
  • Hymenolepis nana / genetics*
  • Male
  • Microscopy, Electron, Transmission
  • Mutation*
  • Phylogeny
  • Polymerase Chain Reaction


  • DNA, Helminth