Unanticipated cytodiagnosis of filariasis: A Study of 16 cases

  • Dr Ruchee Khandelwal Associate Professor, Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly (U.P), India
  • Dr. Neha Agnihotri Clinical Associate, Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly (U.P), India
  • Dr. Surabhi Pandey Assistant Professor, Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly (U.P), India
Keywords: Filariasis, Fine needle aspiration cytology, Microfilariae

Abstract

Background: Bancroftian Filariasisisatropical and sub tropical disease caused by Wuchereriabancrofti and transmitted by the Culexmosquitoes. The diagnosis of it is conventionally made by demonstrating microfilaria eintheperipheral blood smear. Microfilariae and adult filarial worm have been incidentally detected in fine needle aspirate of swelling at various sites in amicrofilaremic patients. Currently 1.4 billion people worldwide are at risk of being infected. In India 600 million people are at risk of filariasis.Cytology has important role in the diagnosis of occult Filariasis.

Objectives: To discuss the role of FNAC in diagnosing occult Filariasis. Material and Methods: This is a retrospective study carried out in the Department of Pathology at SRMS IMS, Bareilly, Uttar Pradesh. Aspiration was made by 22-23 gauze needle, smears were stained by Papanicolaou and May-GrünwaldGiemsa stain.

Result:16 cases of cytological specimensincidentallyshowed microfilaria without any clinical suspicion which included breast lumps (three cases), thyroid swelling (three cases), lymph nodes (two cases), subcutaneous swelling (two cases), ascitic fluid (one case), pleural fluid (one case), lung mass (one case), scrotal swelling (one case), cervical smear (one case) and space occupying lesion in liver (one case). Fragments of adult worm were reported in four cases. Only one patient with scrotal swelling had microfilaremia.

Conclusion:FNAC can play an important role in diagnosing occult Filariasis in clinically unsuspected cases.

Downloads

Download data is not yet available.

References

Diseases, W. (2018). Lymphatic filariasis: reasons for hope. [online] Who.int. Available at: http://www.who.int/iris/handle/10665/63502 [Accessed 27 Jan. 2018].

Michael E, Bundy DA, Grenfell BT. Re-assessing the global prevalence and distribution of lymphatic filariasis.Parasitology. 1996 Apr;112 ( Pt 4):409-28.

World Health Organ Tech Rep Ser. 1992;821:1-71. Lymphatic filariasis: the disease and its control.Fifth report of the WHO Expert Committee on Filariasis. [No authors listed]. PMID: 1441569.

Kasper LD, Fauci SA, Longo LD, Braundwald E, Hauser SL, Jameson LJ: Filarial and related infections. In Harrison’s Principles of Internal Medicine. Volume 1. Sixteenth edition. New York, McGraw-Hill, 2005, pp 1260–5.

Warrel AD, Cox MT, Firth DJ, Benz JE Jr: Nematodes (round worms). In Oxford Textbook of Medicine. Volume 1. Fourth Edition. New York, Oxford University Press, 1993, pp 785–80.

Chatterjee KD. Helminthology – section II. Parasitology, protozoology and helminthology. 12th ed. Calcutta kalighat1980: 174-82.

Sharma, Prashant & Kumar, Neeta & Jain, Parul& Gur, Renu& Jain, Shyama. (2005). Chronic Wuchereriasis Presenting as a Vaginoperineal Fistula. Acta Cytologica - ACTA CYTOL. 49. 335-338. doi: https://doi.org/10.1159/000326160.

Park K: Epidemiology of communicable disease. In: Textbook of Preventive and Social Medicine.18th ed. Jabalpur, BanarsidasBhanot Publishers; 2005: 211-6.

Bahgat MM, Saad AH, El-Shahawi GA, Gad AM, Ramzy RM, Ruppel A, Abdel-Latif M. Cross-reaction of antigen preparations from adult and larval stages of the parasite Setaria equina with sera from infected humans with Wuchereriabancrofti.East Mediterr Health J. 2011 Aug;17(8):679-86.

Yenkeshwar PN, Dinker T, Sudhakar K, Bobhate K. Microfilariae in fine needle aspirates: A report of 22 cases. Indian J pathol microbial 2006; 49: 365-9.

Chatterjee KD. Phylum nemathelminthes.In : Parasitology, protozoology and helminthology. 13thed. New delhi, CBS publishers.

Fernandes H, Naik CNR, Marla NT, Arora D. Microfilaria in cytological smears of hepatocellular carcinoma. J Cytol 2007; 24: 158-9.

Pandit AA, Shah RK, Shenoy SG. Adult filarial worm in a fine needle aspirate of a soft tissue swelling.Acta Cytol. 1997 May-Jun;41(3):944-6.

Varghese R, Raghuveer CV, Pai MR, Bansal R. Microfilariae in cytologic smears: a report of six cases.Acta Cytol. 1996 Mar-Apr;40(2):299-301.

Pandit A, Prayag AS. Microfilaria in a thyroid aspirate smear: an unusual finding.Acta Cytol. 1993 Sep-Oct;37(5):845-6.

Dey P, Walker R. Fine needle aspiration cytology of microfilaria in skin nodule. ActaCytol 1994; 38-114.

Jayaram G. Microfilariae in fine needle aspirates from epididymal lesions. Acta Cytol. 1987 Jan-Feb;31(1):59-62.

Bapat KC, Pandit AA. Filarial infection of the breast. Report of a case with diagnosis by fine needle aspiration cytology.Acta Cytol. 1992 Jul-Aug;36(4):505-6.

Kapila K, Verma K. Diagnosis of parasites in fine needle breast aspirates.Acta Cytol. 1996 Jul-Aug;40(4):653-6.

Rukmangadha N, Shanthi V, Kiran CM, Nalini PK, Sarella JB. Breast filariasis diagnosed by fine needle aspiration cytology: A case report. Indian J patholmicrobiol 2006;49: 243-4.

Sahu KK, Pai P, Raghuveer CV, Pai RR. Microfilaria in a fine needle aspirate from the salivary gland.Acta Cytol. 1997 May-Jun;41(3):954.

Walter A, Krishnaswami H, Cariappa A. Microfilariae of Wuchereriabancrofti in cytologic smears.Acta Cytol. 1983 Jul-Aug;27(4):432-6.

Kapila K and VermaK. Coexistent metastatic malignant melanoma cells and wuchureriabancroftimicrofilariae in urinary sediment. Actacytol 1986; 30:696-7.

Vassenwala SM, Khan AA. Microfilaria in urinary sediment smears in association with carcinoma of urinary bladder. Report of two cases with review of literature. J Cytol 1990; 7:19-23.

Joshi AM, Pangarkar MA, Ballal MM. Adult female Wuchereriabancrofti: nematodes in a fine needle aspirates of the lymph node (left). Actacytol 1995; 39:138.

Affandi MZ. Microfilaria in endometrial smear. ActaCytol 1980; 24: 173-4.

Lahiri VL: Micorfilaria in nipple secretions: ActaCytol 1975; 19: 154.

Lahiri VL. Microfilariae in nipple secretion.Acta Cytol. 1975 Mar-Apr;19(2):154.

Avasthi R, Jain AP, Swaroop K, Samal N. bancroftian microfilariasis in association wih pulmonary tuberculosis. Report of a case with diagnosis by fine needle aspiration. ActaCytol 1991; 35: 717-8.

Anupindi L, Sahoo R, Rao RV, Verghese G, Rao PVP: Micorfialria in bronchial brushings cytology of asymptomatic pulmonary lesions: A report of two cases. ActaCytol 1993; 37: 397-9.

Sharma S, Rawat A, Chowhan A. Microfilariae in bone marrow aspiration smears, correlation with marrow hypoplasia: a report of six cases.Indian J PatholMicrobiol. 2006 Oct;49(4):566-8.

Aron M, Kapila K, Sarkar C, Verma K. Microfilariae of Wuchereriabancrofti in cyst fluid of tumors of the brain: a report of three cases.Diagn Cytopathol. 2002 Mar;26(3):158-62.

Marathe A, Handa V, Mehta GR, Mehta A, Shah PR. Early diagnosis of filarial pleural effusion.Indian J Med Microbiol. 2003 Jul-Sep;21(3):207-8.

Mehrotra R, Gupta OP, Gupta RK. Filarial ascites clinically mimicking malignancy. ActaCytol 1996; 40: 1329-30.

Sinha BK, Choudhury M, Sinha R. Microfilaria in peritoneal fluid from an amicrofilaremic, pregnant woman.Acta Cytol. 2001 Sep-Oct;45(5):898-9.

Charan A, Sinha K: Constrictive pericarditis following filarial effusion. Indian Heart J 1975; 25: 213-5. [PubMed]

Gupta S, Sodhani P, Jain S, Kumar N. Microfilariae in asscociation with neoplastic lesions: report of five cases. Cytopathology 2001; 12: 120-126.

Kaushal S, Iyer VK, Mathur SR. Morphological Variations in Microfilaria of Wuchereriabancrofti in Cytology Smears: A Morphometric Study of 32 Cases. Actacytol2012;56:431-8.

Hira PR. Wuchereriabancrofti: the staining of the microfilarial sheath in giemsa and haematoxylin for diagnosis.Med J Zambia. 1977 Aug-Sep;11(4):93-6.

Mitra SK, Mishra RK, Verma P. Cytological diagnosis of microfilariae in filariasis endemic areas of eastern utter Pradesh. J cytol2009;26:11-4.

Chowdhary M, Langer S, Aggarwal M, Agarwal C. Microfilaria in thyroid gland nodule.Indian J PatholMicrobiol. 2008 Jan-Mar;51(1):94-6.

Jha A, Shrestha R, Aryal G, Pant AD, Adhikari RC, Sayami G. Cytological diagnosis of bancroftian filariasis in lesions clinically anticipated as neoplastic.Nepal Med Coll J. 2008 Jun;10(2):108-14.

Andola SK, Naik AA. Microfilaria and filarial granulomas from fine needle aspirates: a study of 25 cases.Southeast Asian J Trop Med Public Health. 2011 Nov;42(6):1351-8.

Mallick MG, Sengupta S, Bandyopadhyay A, Chakraborty J, Ray S, Guha D. Cytodiagnosis of filarial infections from an endemic area.Acta Cytol. 2007 Nov-Dec;51(6):843-9.

Kaur R, Phillip KJ, Masih K, Kapoor R, Johnny C. Filariasis of the breast mimicking inflammatory carcinoma. LabMedicine 2009; 40:683-5.

Saha K, Kapila K, Verma K. Parasites in fine needle breast aspirate-assesment of host tissue response. Postgrad Med J 2002; 78:165-7.

Prasoon D. Breast filariasis mimicking Paget's disease.Acta Cytol. 1998 Mar-Apr;42(2):452-3.

Ahuja M, Pruthi SK, Gupta R, Khare P. Unusual presentation of filariasis as an abscess: A case report.J Cytol. 2016 Jan-Mar;33(1):46-8. doi: https://dx.doi.org/10.4103%2F0970-9371.175520.

Akhtar S, Gumashta R, Pande S, Maimoon S, Mahore S. Cytodiagnosis of filarial infection on a non healing ulcer: an unusual presentation and review of literature. Prog Health Sci 2012;2(2):195-9.

Arora VK, Gowrinath K. Pleural effusion due to lymphatic filariasis. Indian J Chest Dis Allied Sci 1994;36:159-61.

Sabesan S, Palaniyandi M, Das PK, Michael E. Mapping of lymphatic filariasis in India.Ann Trop Med Parasitol. 2000 Sep;94(6):591-606.

Venkateswaran CH. Surgical treatment of filarial scrotum and penis.J Indian Med Assoc. 1950 Jul;19(10):368-70.

Pandit CG, Pandit SR, Iyer IV. The adhesion phenomenon in filariasis: A preliminary note. Indian J Med Res. 1929;16:946–53.

Basu A, Gon S, Bera S, Chakravati S. Breast Filariasis : A rare cytomorphological diagnosis. J Pak Med Stud 2013; 3(2):103-5.

Bhardwaj S, Mahajan D, Attri MR. Filariasis of the breast. JK Science 2007;9(2):98-9.

Jain S, Sodhan P, Gupta S, Sakhuja P, Kumar N. Cytomorphology of Filariasis Revisited. Expansion of the Morphologic Spectrum and Coexistence with Other Lesions. Actacytol2001;45:186-91.

Valand AG, Ramraje SN, Surase S. Microfilariae of WuchereriaBancrofti in cervicovaginalsmears.Indian J Pathol Microbiol.2004;47(4):597-8.

Dhanya R.C.S, jayaprakash HT. Microfilariae, a Common Parasite in an Unusual Site: A Case Report with Literature Review. Journal of Clinical and Diagnostic Research. 2016; 10(4): 8-9.

Reddy PS, Sabhikhi AK, Rai R. Microfilariae in fine needle aspirates of the liver.Acta Cytol. 1998 Mar-Apr;42(2):454.

Pandey A, Masood S, Awasthi NP. Cystic microfilarial infestation of the liver: a rare presentation.Int J Infect Dis. 2015 Feb;31:15-7. doi: https://doi.org/10.1016/j.ijid.2014.12.008. Epub 2014 Dec 12.

Arakeri SU, Yelikar BR. Microfilarae in cytological smears of hepatocellular carconima. J Cytol2007;24:158-9.

Konar A. Microfilaria in lung--diagnosis by FNAC.Indian J PatholMicrobiol. 2003 Apr;46(2):279-80.

Agarwal R, Khanna D, Barthwal SP: Microfilaria in a cytologic smear from cavernous hemangioma of the liver: A case report. ActaCytol 1998; 42:781-2.

Ahluwalia C, Choudhury M, Bajaj P. Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone.Diagn Cytopathol. 2003 Jul;29(1):31-2.

Mohan G, Chaturvedi S, Misra PK. Microfilaria in a fine needle aspirate of primary solid malignant tumor of the maxillary antrum. A case report.Acta Cytol. 1998 May-Jun;42(3):772-4.

Aron M, Kapila K, Sarkar C, Verma K. Microfilariae of Wuchereriabancrofti in cyst fluid of tumors of the brain: a report of three cases.Diagn Cytopathol. 2002 Mar;26(3):158-62.

Gupta K, Sehgal A, Puri MM, Sidhwa HK. Microfilariae in association with other diseases. A report of six cases.Acta Cytol. 2002 Jul-Aug;46(4):776-8.

Agarwal PK, Srivastava AN, Agarwal N. Microfialria in association with neoplasms. A report of six cases. ActaCytol 1982; 26: 480-90.

Munjal S, Gupta JC, Munjal KR. Microfilariae in laryngeal and pharyngeal brushing smears from a case of carcinoma of the pharynx.Acta Cytol. 1985 Nov-Dec;29(6):1009-10.

Kapila K, Verma K. Microfilaria in urinary sediment: coexistent metastatic melanoma cells and Wuchereriabancrofti. ActaCytol 1986; 30: 696-7.

Justus PG, Kitchens CS. Secondary leukemia with munchausen filariasis.Ann Intern Med. 1976 Nov;85(5):685.

Devi KR, Bahuleyan CK. Lymphangiosarcoma of the lower extermity associated with chronic lymphoedema of filarial origin.Indian J Cancer. 1977 Jun;14(2):176-8.

Mohan S, Andley M, Talwar N, Ravi B, Kumar A. An unusual association with carcinoma pancreas: a case report.Cytopathology. 2005 Aug;16(4):215-6.

Agrawal K, Mekhala A, Chitra S, Narasimhan R, Ratnakar C. Wuchereriabancrofti microfilariae in the dentigerous cystic fluid: an unusual presentation.Ann Plast Surg. 1998 Aug;41(2):205-7.

Atal P, Choudhury M, Ashok S. Coexistence of carcinoma of the breast with microfilariasis.Diagn Cytopathol. 2000 Apr;22(4):259-60.

Unanticipated cytodiagnosis of filariasis: A Study of 16 cases
CITATION
DOI: 10.17511/ijmrr.2018.i03.06
Published: 2018-03-31
How to Cite
1.
Khandelwal R, Agnihotri N, Pandey S. Unanticipated cytodiagnosis of filariasis: A Study of 16 cases. Int J Med Res Rev [Internet]. 2018Mar.31 [cited 2024Dec.23];6(3):166-7. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/973
Section
Original Article