Cytodiagnosis of filariasis from a swelling of arm

Abstract

Cytological demonstration of microfilaria and adult worms often helps in diagnosis of asymptomatic filarial cases. But demonstration of microfilaria in cytological smears from upper extremity lesions is seldom reported. We are presenting a 32-year-old female patient with elongated, small subcutaneous swelling in the medial aspect of right lower arm. Aspirates from the lesion demonstrate microfilaria though there is no eosinophilia or microfilaremia on subsequent examination of blood sample. In endemic areas, filariasis should always be considered as a possible diagnosis during cytological assessment of any swelling.

Cytological diagnosis of bancroftian filariasis presented as a subcutaneous swelling in the cubital fossa: an unusual presentation

“…The diagnosis of filarial infection in symptomatic cases with typical clinical presentation is often easy and straightforward, but demonstration of microfilariae in circulating blood is the only conventional means by which one can make definite diagnosis [ 10 ]. Unfortunately, in endemic areas, a majority of the affected individuals remain asymptomatic with continued disease transmission [ 11 ]. Regardless of high incidence of this parasite in an endemic zone, microfilaremia is often absent and presence of microfilariae in cytological smears and body fluids is an incidental finding.…”

“…As the parasite circulate in the lymphatic and vascular systems, appearance of filarial organism in tissue fluids and exfoliated surface material probably occurs due to conditions causing lymphovascular obstruction resulting into extravasations of blood and release of microfilariae. The lymphatic blockade and vessel obstruction are determined by local factors such as tumors, inflammation, trauma or stasis [ 11 , 12 ]. Cytology has an important role in the diagnosis of subclinical filariasis and can demonstrate these extravasated larvae in tissue spaces or fluids as was evident in our case.…”

Role of Fine Needle Aspiration Cytology (Fnac) in Diagnosis of Asymptomatic Microfilariasis

“…[5] In rest Brugia Malayi is the cause. [6] The disease mainly involves the lymphatic system of the body, lymphatics of the lower limbs, retroperitoneal tissue, spermatic cord, epidydimus, mammary glands are more frequently involved. [7] Filariasis consists of spectrum of clinical presentations ranging from asymptomatic microfilaremia, acute lymphadenitis, chronic lymphadenitis, edema of limbs and genitalia & tropical pulmonary eosinophilia.…”

Incidental diagnosis of filariasis in association with carcinoma of gall bladder: Report of a case evidenced on ultrasound-guided fine-needle aspiration cytology with review of the literature

“…[ 1 2 ] In India filarial infections are commonly caused by two closely related nematodes– Wuchereria bancrofti and Brugia malayi . [ 1 3 ] W. Bancrofti is causative agent for 98% cases of lymphatic filariasis and B. malayi is for the rest 2%. [ 3 ] The disease mainly affects the lymphatics of lower limbs, spermatic cord, epididymis and retroperitoneal lymphatics, etc.…”

“…[ 1 3 ] W. Bancrofti is causative agent for 98% cases of lymphatic filariasis and B. malayi is for the rest 2%. [ 3 ] The disease mainly affects the lymphatics of lower limbs, spermatic cord, epididymis and retroperitoneal lymphatics, etc. [ 1 ] Though India is an endemic region for filariasis, still finding microfilaria in fine-needle aspiration cytology (FNAC) smears is quite unusual.…”