Incidental detection of two adult gravid filarial worms in breast: a case report

Santosh, Tummidi; Kothari, Kanchan; Patil, Rahul; Singhal, Shruti S.; Keshan, Pooja

doi:10.1186/s13104-017-2709-3

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Lymphatic vessels of the definitive host (man) harbours the adult worms of Wuchereria bancrofti and microfilaria are released in peripheral blood ( 3 ). However, all components of filarial worm infestation such as adult filarial worm with eggs and microfilaria in varying stages are rarely found together on fine needle aspiration cytology (FNAC) of lymph node swellings.…”

Section: Introductionmentioning

confidence: 99%

Isolated epitrochlear filarial lymphadenopathy: cytomorphological diagnosis of an unusual presentation

Sahu

Gupta²,

Bhardwaj³

et al. 2018

TJPATH

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Filariasis is a major public health problem in tropical countries like India. Despite the large number of people at risk, detection of eggs with or without larva (microfilaria) on fine-needle aspiration cytology is very unusual, especially in an uncommon site or incidentally detected in clinically unsuspected cases of filariasis with the absence of microfilariae in the peripheral blood. A 19-year-old male presented with swelling over medial aspect of left arm (just above the elbow), with no other specific signs and symptoms. Fine needle aspiration cytology revealed an adult gravid female filarial worm in a background of reactive lymphoid cells and lymphohistiocytic clusters. We report a case with elaborate fine needle aspiration cytology findings of filarial worm infestation with unusual presentation of isolated epitrochlear lymph node involvement in a clinically unsuspected case and recommend clinicians and pathologists to consider a high index of suspicion for such infections at uncommon sites especially in endemic territories, as early diagnosis and treatment prevent the more severe manifestations of disease.

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Section: Introductionmentioning

confidence: 99%

Isolated epitrochlear filarial lymphadenopathy: cytomorphological diagnosis of an unusual presentation

Sahu

Gupta²,

Bhardwaj³

et al. 2018

TJPATH

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“…However, adult filarial worms have been demonstrated at various sites including lymph nodes from various locations, arm nodules, salivary glands, and epididymis. [6] Filariasis is mostly an incidental finding on cytology, frequently missed on FNAC. A careful examination of cytological smear, especially in high-risk groups and endemic regions, is a must for early detection and treatment.…”

Section: Discussionmentioning

confidence: 99%

Filariasis presenting as a solitary testicular mass

et al. 2019

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In an endemic country like India, the occurrence of filariasis is very common, especially in the states of Uttar Pradesh, Bihar, Jharkhand, Odisha, Andhra Pradesh, and Tamil Nadu. The present study describes the case of a male from a nonendemic state who presented with a testicular lump. Fine-needle aspiration cytology (FNAC) of the lump revealed many adult filarial worms. The appearance of adult filarial worms in different sites, other than lymph nodes and lymphatic vessels, are relatively rarer and should always be reported. Filariasis remains asymptomatic for a long time and responds very well to treatment if diagnosed early. Despite the availability of multiple diagnostic options, FNAC holds a great importance in diagnosing filariasis, especially in cases where there are normal eosinophil counts and no peripheral filarial parasite. Finally, careful examination of cytological smear for the parasite in high-risk groups is helpful in labeling the disease in early asymptomatic states.

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“…In majority of such cases, a cytological diagnosis is made on the basis of demonstration of microfilariae, with typical morphology, in the smears. However, in rare circumstances, incidentally migrated adult filarial worms can also be aspirated from these swellings . We report a case of bancroftian filariasis presenting as a solitary subcutaneous arm swelling, with cytology demonstrating adult gravid worm, embryoid forms and microfilariae.…”

Section: Introductionmentioning

confidence: 92%

“…However, in rare circumstances, incidentally migrated adult filarial worms can also be aspirated from these swellings. [7][8][9][10][11] We report a case of bancroftian filariasis presenting as a solitary subcutaneous arm swelling, with cytology demonstrating adult gravid worm, embryoid forms and microfilariae.…”

Section: Introductionmentioning

confidence: 99%

Vermi‐trouble: Cytology of an arm swelling

Gupta

Rajwanshi

2018

Diagnostic Cytopathology

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Filariasis is one of the major health problems in tropical and subtropical countries of the world. It can be caused by any of the following nematodes: Wuchereria bancrofti, Brugia malayi, Brugia timori, Loa loa, Oncocerca volvulus, Mansonella perstans, Mansonella ozzardi, Mansonella streptocerca and Dirofilaria spp. Of all these, W. bancrofti and B. malayi are the most common causes of lymphatic filariasis with the former accounting for more than 90% of all the cases. 1 Bancroftian filariasis is primarily confined to the lymphatic system with the adult worms residing in the lymph nodes or the larger lymphatic channels and releasing numerous microfilariae into the peripheral circulation of the definitive host. The most common presentations include asymptomatic microfilaremia, acute adeno-lymphangitis or chronic lymphatic disease causing lymphedema. Primary mode of diagnosis is the demonstration of microfilariae in the peripheral blood of these patients, sampled at night, keeping in mind the nocturnal periodicity of these parasites. 2 Bancroftian filariasis has also been reported involving the epididymis, testes, breast, thyroid, bone marrow, retroperitoneum and rarely the subcutaneous and the soft tissues. 1,3-7 Fine needle aspiration cytology often serves as a useful modality of diagnosis in cases presenting as palpable swellings. In majority of such cases, a cytological diagnosis is made on the basis of demonstration of microfilariae, with typical morphology, in the smears. However, in rare circumstances, incidentally migrated adult filarial worms can also be aspirated from these swellings. 7-11 We report a case of bancroftian filariasis presenting as a solitary subcutaneous arm swelling, with cytology demonstrating adult gravid worm, embryoid forms and microfilariae. | CASE REPORTA 32-year-old woman presented with a single, painless, subcutaneous swelling over the medial aspect of right arm from the last 20 days. The clinical suspicion was of a lipoma. On examination, the swelling was soft, non-tender and 2 cm in maximum dimension with normal overlying skin. Fine needle aspiration was done from the swelling using 22-guage needle attached to a 20 mL syringe, fitted onto a metallic handle. The aspirate yielded clear fluid with some whitish flecks. The fluid was collected in the cytorich red fixative for subsequent liquid based cytology smear (LBS) preparation (SurePath). The smears were stained with May-Grunwald Giemsa (MGG) and hematoxylin and eosin (H&E) stain and showed multiple fragments of an adult gravid female worm with an outer cuticle layer and numerous coiled larvae and embryoid bodies within the body cavity. Many thousands of microfilariae were seen coming out of the ruptured body cavity of the worm. The microfilariae were ensheathed with the central part showing multiple somatic cells also known as the nuclei. The nuclei were not seen extending into the cephalic and the tail ends of the microfilariae, thereby confirming the filarial species as W. bancrofti. The background showed only occasional neutro...

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Incidental detection of two adult gravid filarial worms in breast: a case report

Cited by 5 publications

References 7 publications

Isolated epitrochlear filarial lymphadenopathy: cytomorphological diagnosis of an unusual presentation

Isolated epitrochlear filarial lymphadenopathy: cytomorphological diagnosis of an unusual presentation

Filariasis presenting as a solitary testicular mass

Vermi‐trouble: Cytology of an arm swelling

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