Adult filarial worm from the breast aspirate of a young man

Abstract

Microfilariae and adult filarial worm have been incidentally detected in fine needle aspirates of various lesions in clinically unsuspected cases. Here we report a male patient who presented with a tender breast nodule and single enlarged lymph node. Fine Needle Aspiration (FNA) yielded 1 ml of yellow coloured fluid and single thread like worm measuring 6 9 0.2 cm. A diagnosis of breast abscess with a worm morphologically consistent with filariasis was offered. A follow up visit after 2 months showed regression of the breast lesion and the lymph node. Filariasis of the breast is an uncommon condition and can cause a diagnostic dilemma at times. FNA cytology appears to be a more convenient and effective diagnostic tool in patients with mass lesions. Demonstration and identification of the parasite in smears helps in avoiding surgical excision and early institution of prompt therapy especially in young patients.

Breast filariasis masquerading as carcinoma

“…There can be skin erythema, edema, and puckering of skin with a characteristic peau d’orange appearance, as seen in case 1. [ 6 ] They mimic malignancy and pose a diagnostic challenge. Dead worms can also elicit an inflammatory reaction forming a mass with eosinophilic and granulomatous inflammation, further presenting as a palpable lump.…”

“…[ 7 ] Most of such filarial breast lesions are described in female patients. [ 6 ] There are reports of concomitant filariasis in carcinoma breast and there are occasional case reports of breast filariasis in males, including one which mentions filariasis presenting as gynecomastia. [ 5 7 ] Our second patient was an elderly male; his breast lump was clinically suspected to be malignant.…”

A rare case of unilateral breast filariasis mimicking chronic mastitis

“…3 Calcified adult filarial worms in the tissue can elicit pronounced inflammatory reaction compared to live worms, mimicking the inflammatory breast disease. 4 Sometimes an already compromised lymphatics can cause suppurative inflammation causing superadded fungal or bacterial infection. The solid tissue reaction due to localized fibroblastic and histiocytic proliferation around degenerated adult worm can mimic mastitis as seen in our case.…”