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

Sinha, Rajani; Sengupta, Sanjay; Pal, Subrata; Adhikari, Anindya

doi:10.4103/0970-9371.145662

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…The association with benign and malignant conditions is mostly incidental. [ 27 28 29 30 31 32 33 34 35 36 ] As these parasites circulate in the vascular and lymphatic systems throughout the body, their appearance in tissue fluids, exfoliated surface material, and fine-needle aspirates would probably occur only under conditions of lymphatic or vascular obstruction or extravasation. Such aberrant migration to these “dead end” sites is probably determined by local factors such as mechanical blockade of the lumen by dead worms,[ 6 ] damage to vessel wall by inflammation or trauma, and lymphatic blockade by scars or tumors.…”

Section: Discussionmentioning

confidence: 99%

Wuchereria bancrofti and cytology: A retrospective analysis of 110 cases from an endemic area

Prasoon¹,

Agrawal²

2020

J Cytol

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Background: Wuchereriasis is a significant cause of chronic morbidity. It can affect any organ/tissue in the body. Fine-needle aspiration cytology (FNAC) is an easy method for its detection. A comprehensive analysis of the various facets involved has not been discussed in detail in any publication. Materials and Methods: A twenty-six year (February 1994 to January 2020) retrospective audit of all patients who were cytologically diagnosed with wuchereriasis was performed. Data regarding age, sex, organ/tissue involved, and presence of co-existing disease were noted. Hematoxylin and eosin (H and E) and May-Grünwald-Giemsa (MGG) stained slides were screened for microfilaria, adult worm, larval forms, microfilaria ghosts, epithelioid cell granuloma, and eosinophils. Results: Audit yielded 19,323 cases of which 110 had wuchereriasis giving an incidence of 0.57%. The 11–30 year age group accounted for 41.8% cases. Male: female ratio was 1.04:1. Duration of disease at presentation ranged from 3 days to 24 years. Lymph node was the commonest site involved (40%), followed by soft tissue (23.6%) and female breast (14.5%). Highest parasitic load was encountered in female breast aspirates. Microfilaria bancrofti was seen in 105 (95.4%) cases. In the five cases where microfilaria bancrofti was not encountered, diagnosis was established by the presence of adult gravid female worm (2 cases), coiled larvae (2 cases), and both adult gravid female worm and coiled larvae (1 case). Microfilaria ghosts were seen in 18.2% cases. Coexisting benign and malignant diseases were encountered in 17.3% and 13.6% cases, respectively. Conclusion: FNAC provides a simple and inexpensive means of detecting wuchereriasis and is preferred over histopathology. All stages of development of this nematode in human beings are identified in cytology. Microfilaria ghost is a useful clue in screening. The presence of granuloma and eosinophilic infiltrate indicates tissue reaction only. Patients with asymptomatic microfilaraemia should be reported in cytology as they merit treatment.

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Section: Discussionmentioning

confidence: 99%

Wuchereria bancrofti and cytology: A retrospective analysis of 110 cases from an endemic area

Prasoon¹,

Agrawal²

2020

J Cytol

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“…Few case reports of coexistence of microfilariae with neoplastic lesions such as squamous cell carcinoma of maxillary antrum, carcinoma of the pharynx, follicular carcinoma of the thyroid, carcinoma of the breast, carcinoma of the pancreas, carcinoma of the gall bladder, transitional cell carcinoma of the bladder, metastatic melanoma to the bladder, seminoma of undescended testis, leukemia, meningioma, and craniopharyngioma are reported in the literature. [242526] The presence of microfilaria in metastatic lymph nodes could be due to transmigration of microfilaria along with metastatic tumor emboli. Larvae may be present in the vasculature and seen on cytology following rupture of vessels during aspiration, especially in highly vascular tumors.…”

Section: Discussionmentioning

confidence: 99%

Utility of cytology in the diagnosis of parasitic infestation: A retrospective study

et al. 2019

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Background:Parasitic infestation is one of the serious health problems in developing countries. Parasitic infestation is usually asymptomatic and does not cause disease as it may eventually lead to the death of both organism and host.Materials and Methods:This was a retrospective study done over a period of 5 years from 2013 to 2018. The study included 26 cases of parasitic infestations diagnosed on fine-needle aspiration cytology (FNAC) as well as fluid cytology.Results:Hydatidosis, cysticercosis, and filariasis were the parasitic infestations observed in this study, of which hydatidosis was the most common infestation. The predominant age group was 20–85 years old, with a mean age of presentation being 55 years. There was male predominance with a male–female of 9:1.Conclusion:FNAC and fluid cytology are rapid diagnostic tools that aid in the early diagnosis of parasitic infestations. In parasitic infestations presenting as visceral cystic lesions, thorough examination with proper clinical correlation aid in early management. In cases with coexistent malignancy, cytology plays a major role in the diagnosis of silent carriers of infection.

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“…Coexistence of microfilaria in association with malignancy has been reported by many previous authors. [ 13 14 ] Presence of microfilaria within a neoplasm is a chance association. However, increased vascularity and lymphatics in a malignancy cause increased concentration of microfilariae at the local site in a previously affected person.…”

Section: Discussionmentioning

confidence: 99%

Cytological findings of microfilariae in different sites: A retrospective review of 22 cases from endemic region

et al. 2018

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Background:Filariasis is a major health problem in India. Despite the high prevalence, microfilariae are rarely found in cytology smears. Most of the cases are incidentally found, solely or in association with other pathologies.Aims and Objectives:The study was undertaken to analyze the prevalence and cytology findings of cases of incidentally found microfilariae in cytology smears (fine-needle aspiration cytology [FNAC]/body fluids) from different body parts.Materials and Methods:This was a retrospective study over 5 years, where the cases of microfilariae in aspirates from swelling of different locations and body fluids were reviewed, and clinic-pathological data were analyzed.Results and Analysis:Out of 16,738 cases of FNAC and 882 cases of fluid cytology, 22 cases (0.124%) of incidental finding of microfilaria were documented in cytology smears. The cases were diagnosed from lymph nodes (5 cases), skin and soft tissue (4 cases), scrotal (4 cases), breast (3 cases), thyroid (2 cases), and pleural fluid (2 cases). We found eosinophilia in 15 cases (68.18%) of filarial lesions. We found two cases of incidental findings of microfilariae in association with malignant lesions.Conclusion:Filariasis should be considered as differential diagnosis of swelling of lymph nodes, skin, soft tissue, inguinoscrotal region, and other sites as well. Careful screening of cytology smears may help in detection of incidental cases in the association of other pathologies.

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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

Cited by 9 publications

References 6 publications

Wuchereria bancrofti and cytology: A retrospective analysis of 110 cases from an endemic area

Wuchereria bancrofti and cytology: A retrospective analysis of 110 cases from an endemic area

Utility of cytology in the diagnosis of parasitic infestation: A retrospective study

Cytological findings of microfilariae in different sites: A retrospective review of 22 cases from endemic region

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