Incidental Diagnosis of Filariasis in Superficial Location by FNAC: A Retrospective Study of 10 Years

Khare, Pratima; Kala, Pooja Sharma; Jha, Aditi; Chauhan, Nidhi; Chand, Priyanka

doi:10.7860/jcdr/2014/9906.5266

Cited by 14 publications

(40 citation statements)

References 8 publications

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“…All cases showed viable microfilaria (Figure 1a It is worthwhile to note that the prevalence of filariasis is low in the NCR, where this study was conducted. The detection rate of 0.03% detected in this study is similar to the value of 0.078% in other studies conducted in Delhi/NCR, [6] while it is low as compared to studies in endemic areas. [4,[8][9][10] Among the various nematodes which can cause filariasis, Wuchereria bancrofti is responsible for 90% cases worldwide and 99.4% cases in India, while Brugia malayi accounts for the remainder.…”

Section: Resultssupporting

confidence: 87%

“…Predominance in the third decade has been noted in other studies. [5,6] A mild preponderance towards females is seen, possibly because of the inclusion of a large number of cervico-vaginal smears, constituting 40.32% of the study group. Only one case in our study, an inguinal swelling of 3 days' duration, was accompanied by acute manifestations like fever or leucocytosis.…”

Section: Resultsmentioning

confidence: 99%

“…[1,2] This is corroborated by the detection of microfilariae of W. bancrofti in all the cases in this study, similar to other Indian studies. [4][5][6][7][8][9][10][11][12][13][14][15][16] Filariasis causes a spectrum of diseases including asymptomatic amicrofilaremia, asymptomatic microfilaremia, acute lymphangitis, lymphadenitis, lymphedema, chronic lymphadenitis, elephantiasis and tropical pulmonary eosinophilia.…”

Section: Resultsmentioning

confidence: 99%

“…[3] These are the cases detected in our study, similar to other studies, where detection of microfilariae in cytological material has been incidental. [4][5][6][7][8][9][10][11][12][13][14][15][16] In our study, we have additionally retrieved the radiologic data in all cases, which was of no additional help, and was even misleading in two cases (1 thyroid, 1 breast swelling). Predominance in the third decade has been noted in other studies.…”

Section: Resultsmentioning

confidence: 99%

“…[1,3] Despite its high incidence, it is unusual to detect microfilaria in cytological smears. There have been reports of single or small number of cases of microfilariae in fine needle aspiration cytology (FNAC) various sites such as breast, [4][5][6][7][8][9][10][11][12][13] lymph nodes, [4,6,[8][9][10][11][12][13][14][15] scrotum, [6,8,9,11] soft tissue swellings, [4][5][6]8,[10][11][12][13] thyroid, [6][7][8][10][11][12][13]15] ovary, [16] lung, [7,12] liver, [4] salivary gland, [5,7] gall bladder, [7] bone marrow, [4,…”

Section: Introductionmentioning

confidence: 99%

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Role of Cytology in Detection of Unsuspected Carriers of Microfilariae: A Retrospective Study in National Capital Region (NCR), India

Dubey¹,

Mishra²,

Srivastav³

et al. 2018

APALM

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Background: Filariasis, a global problem, is a major public health issue in India. Despite its high incidence, it is unusual to detect microfilaria in cytological smears, though unexpected detection of microfilariae in fine needle aspiration cytology (FNAC), exfoliative and fluid cytology have been reported previously. The study analyzed the role of cytology in detection of asymptomatic carriers of microfilariae. Methods:This was a retrospective, observational study and included cases of filariasis from cytological records spanning five years. The epidemiological, clinical, hematologic and radiologic details were noted. The slides were retrieved and examined. Descriptive statistical analysis was utilized.Result: Filariasis was diagnosed in 0.03% of the total cytology cases studied during the period, constituting 0.04% of FNACs (two cases of inguino-scrotal swellings, two of breast lumps, one of thyroid swelling) and 0.02% of cervicovaginal smears (two cases). None of them was clinically suspected to be filariasis. Radiological examination was also misleading. None of the cases demonstrated raised leukocytosis or microfilaremia and eosinophilia was present in 3 cases (42.9%). Apart from microfilariae of Wuchereria bancrofti, eggs were present in one case. This was associated with inflammation in all cases, cell adherence in 42.9% and coexistent hyperplastic and neoplastic conditions in 57.1% cases. Conclusion:The detection of microfilariae in cytological material in the absence of clinical, radiologic or hematologic suspicion, in an area of relatively low prevalence of filaria, points to the need for a high index of suspicion and careful screening of all smears, as cytology may play an important role in the diagnosis of asymptomatic carriers of microfilariae.

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Section: Resultssupporting

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Role of Cytology in Detection of Unsuspected Carriers of Microfilariae: A Retrospective Study in National Capital Region (NCR), India

Dubey¹,

Mishra²,

Srivastav³

et al. 2018

APALM

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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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Microfilaria in cervicovaginal Pap smears: A common parasite hiding in an unusual site: Short series of four cases with literature review

Kumar

Surabhi

et al. 2022

Diagnostic Cytopathology

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In India, filariasis is a severe and significant public health problem. It has been reported to be present in any potential site. However, cervicovaginal Pap smear cytology rarely contains microfilariae despite the widespread occurrence. The occurrence of microfilariae in cervicovaginal smears has seldom been reported, even as an accidental finding. In our retrospective study, four cases of clinically asymptomatic filariasis were diagnosed on a routine cervicovaginal Pap smear from January 2019 to July 2022. All microfilariae were characterized as Wuchereria bancrofti. In the present study, the majority of the cases present vaginal discharge, and the diagnosis was made by cytopathology. Therefore, it is crucial to consider and look for microfilariae in areas where they are not endemic.

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Incidental Diagnosis of Filariasis in Superficial Location by FNAC: A Retrospective Study of 10 Years

Cited by 14 publications

References 8 publications

Role of Cytology in Detection of Unsuspected Carriers of Microfilariae: A Retrospective Study in National Capital Region (NCR), India

Role of Cytology in Detection of Unsuspected Carriers of Microfilariae: A Retrospective Study in National Capital Region (NCR), India

Vermi‐trouble: Cytology of an arm swelling

Microfilaria in cervicovaginal Pap smears: A common parasite hiding in an unusual site: Short series of four cases with literature review

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