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Kumar T, Ganesh R A, Surabhi, Sinha R, Bhadani PP. Microfilaria in cervicovaginal Pap smears: A common parasite hiding in an unusual site: Short series of four cases with literature review. Diagn Cytopathol 2023; 51:E54-E58. [PMID: 36269616 DOI: 10.1002/dc.25065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 01/04/2023]
Abstract
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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Affiliation(s)
- Tarun Kumar
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Abhirami Ganesh R
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Surabhi
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Ruchi Sinha
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Punam Prasad Bhadani
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
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2
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Prasoon D, Agrawal P. Wuchereria bancrofti and Cytology: A Retrospective Analysis of 110 Cases from an Endemic Area. J Cytol 2021; 37:182-188. [PMID: 33776258 PMCID: PMC7984517 DOI: 10.4103/joc.joc_59_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022] Open
Abstract
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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Affiliation(s)
- Dev Prasoon
- Dr. Prasoon's Diagnostic Centre, Munger, Bihar, India
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3
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Vasantham V, Yadav SK, Sarin N, Singh S, Pruthi SK. Incidental detection of microfilaria in cyst fluid of Mucinous cystadenocarcinoma of ovary: A rare case report. Int J Surg Case Rep 2020; 70:56-59. [PMID: 32416487 PMCID: PMC7229237 DOI: 10.1016/j.ijscr.2020.04.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Filariasis is a major health problem in certain parts of India. Microfilaria detection on exfoliative and fluid cytology is extremely rare and it is even very rare to find microfilaria coexistent with neoplastic lesions. PRESENTATION OF CASE A 45-year-old nulliparous female, who presented with complaints of lower abdominal swelling and pain. Initially, a clinical diagnosis of cystadenoma was made. Ascitic fluid cytology of the patient showed 3-dimensional clusters of cells along with an occasional microfilaria. On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made. DISCUSSION Most common cause of lymphatic filariasis is W. bancrofti followed by Brugia species and it affects young adults. The adult form of the filaria lodge in lymph vessels, and due to lymphatic blockage in neoplasms they appear in tissue fluid or on surface material. It is the first case report of microfilaria being detected in ovarian cystic fluid cytology in a patient of Mucinous cystadenocarcinoma of ovary. CONCLUSION Filaria is an incidental finding in most of the cases, hence, cytopathologist should be vigilant and careful screening of all the slides should be done, especially in a country like India, where it is highly endemic.
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Affiliation(s)
- Vyshnavi Vasantham
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shakti Kumar Yadav
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Namrata Sarin
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sompal Singh
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sonam Kumar Pruthi
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India.
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4
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Sarangi J, Arava S, Kumar H. Microfilaria in urine cytology: Report of three cases with review of literature. Diagn Cytopathol 2020; 48:675-678. [PMID: 32259405 DOI: 10.1002/dc.24423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/10/2020] [Accepted: 03/24/2020] [Indexed: 11/10/2022]
Abstract
Lymphatic filariasis is a major public health problem in the developing countries. In India, around 90% of the cases are attributed to Wuchereria bancrofti species morphologically identified as sheathed parasites with tail tip free of nuclei. Microfilariae have been described in urine specimens from patients with chylous and achylous hematuria as well as in a spectrum of other body fluids. Case reports describe their presence in aspirates from numerous neoplasms. However, their association with urothelial carcinoma in urine sediment has been rather rare with only three cases described previously. We report three cases of filariasis in urine cytology, one of which was associated with atypical urothelial cells. Our aim is to stress on the possibility of concomitant filariasis in body fluids and aspirates with other significant findings, especially in endemic areas. Identification of the same renders complete diagnosis and proper treatment to the patient.
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Affiliation(s)
- Jayati Sarangi
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudheer Arava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Hemanth Kumar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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5
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Parashar C, Gupta A, Singh P. Rapid Onsite Evaluation of Unstained Cytosmears: A Vermi-Surprise in the Breast. J Cytol 2020; 37:108-109. [PMID: 32606499 PMCID: PMC7315921 DOI: 10.4103/joc.joc_15_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/25/2019] [Accepted: 02/26/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chetan Parashar
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anurag Gupta
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pradyumn Singh
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Shivkumar V, Deshmukh A, Mangam S, Ghongade P. Cytopathological diagnosis of filariasis by fine-needle aspiration cytology in different body locations: A retrospective study of 5 years in central India. SAUDI JOURNAL FOR HEALTH SCIENCES 2020. [DOI: 10.4103/sjhs.sjhs_63_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Gahine R, Das A, Jain VK, Agrawal A. Rare association of microfilaria with poorly differentiated mucin-secreting metastatic carcinoma in liver aspirate cytology. BMJ Case Rep 2019; 12:12/10/e231618. [PMID: 31645405 DOI: 10.1136/bcr-2019-231618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Filariasis, a neglected tropical disease (NTD), is mainly caused by nematodes-Wuchereria bancrofti, Brugia malayi and B. timori Apart from profoundly disabling and disfiguring major clinical manifestations-lymphoedema, elephantiasis and hydrocoele-asymptomatic microfilaremia is common in endemic areas. Despite this, it is very rare to detect microfilariae in body fluids or aspirates. As per the literature search, this is the third case documenting incidental detection of microfilariae with metastatic deposits in the liver aspirate. Here, a 35-year-old man underwent image-guided fine-needle aspiration cytology of liver nodule. Liver aspirate cytology revealed poorly differentiated mucin-secreting metastatic carcinoma and coincidental presence of microfilariae of W. bancrofti Recently, microfilaria has frequently been found to be associated with the debilitated, immunocompromised condition and various neoplasm/cancer/malignancy. Hence, meticulous investigation should be undertaken to search for hidden pathology, whenever microfilariae are detected; and to deeply scrutinise aspirates for such parasites always, especially in endemic regions.
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Affiliation(s)
- Renuka Gahine
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Aditi Das
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Vishal Kumar Jain
- Radiodiagnosis, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Apurva Agrawal
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
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8
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Shukla SK, Kusum A, Sharma S, Kandari D. Filariasis presenting as a solitary testicular mass. Trop Parasitol 2019; 9:124-126. [PMID: 31579667 PMCID: PMC6767791 DOI: 10.4103/tp.tp_15_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2019] [Indexed: 11/14/2022] Open
Abstract
In an endemic country like India, the occurrence of filariasis is very common, especially in the states of Uttar Pradesh, Bihar, Jharkhand, Odisha, Andhra Pradesh, and Tamil Nadu. The present study describes the case of a male from a nonendemic state who presented with a testicular lump. Fine-needle aspiration cytology (FNAC) of the lump revealed many adult filarial worms. The appearance of adult filarial worms in different sites, other than lymph nodes and lymphatic vessels, are relatively rarer and should always be reported. Filariasis remains asymptomatic for a long time and responds very well to treatment if diagnosed early. Despite the availability of multiple diagnostic options, FNAC holds a great importance in diagnosing filariasis, especially in cases where there are normal eosinophil counts and no peripheral filarial parasite. Finally, careful examination of cytological smear for the parasite in high-risk groups is helpful in labeling the disease in early asymptomatic states.
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Affiliation(s)
- Sushil Kumar Shukla
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Anuradha Kusum
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Siddharth Sharma
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Deepika Kandari
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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9
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Mohan N, Agrawal R, Kumar P. Breast ductal carcinoma with coexistent microfilaria: Diagnosed on cytology. Trop Parasitol 2018; 8:103-105. [PMID: 30693217 PMCID: PMC6329269 DOI: 10.4103/tp.tp_34_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2018] [Indexed: 11/16/2022] Open
Abstract
Filariasis is a major health problem of the tropical and subtropical regions, but filariae are also found in temperate climates. The disease is endemic all over India and microfilariae have been observed as coincidental findings with inflammatory conditions and neoplastic lesions. We report a rare case of a 40-year-old female from a nonendemic area presenting with lump in the left breast. The skin overlying the mass was fungating and ulcerated. Ipsilateral axillary lymph nodes were palpable. Fine-needle aspiration cytology revealed highly cellular smears having ductal epithelial cells arranged in groups, tight clusters, and scattered singly. Cells were large, having pleomorphic round to oval nuclei with prominent nucleoli. Along with these tumor cells, sheathed microfilariae of Wuchureria bancrofti were seen, suggesting a diagnosis of ductal carcinoma with coexistent microfilaria of W. bancrofti. Findings were confirmed on histopathology of the resected specimen following modified radical mastectomy. Coexistent pathologies should always be considered while reporting.
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Affiliation(s)
- Nitesh Mohan
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Ranjan Agrawal
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Parbodh Kumar
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
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10
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Pal S, Mondal S, Pradhan R, Bose K, Chakrabarti S, Sikder M. Cytological findings of microfilariae in different sites: A retrospective review of 22 cases from endemic region. Trop Parasitol 2018; 8:24-28. [PMID: 29930903 PMCID: PMC5991047 DOI: 10.4103/tp.tp_20_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 11/04/2022] Open
Abstract
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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Affiliation(s)
- Subrata Pal
- Department of Pathology, College of Medicine and Sagore Dutta Hospital, Bankura, West Bengal, India
| | - Sajeeb Mondal
- Department of Pathology, College of Medicine and Sagore Dutta Hospital, Bankura, West Bengal, India
| | - Rajashree Pradhan
- Department of Pathology, College of Medicine and Sagore Dutta Hospital, Bankura, West Bengal, India
| | - Kingshuk Bose
- Department of Pathology, B S Medical College, Bankura, West Bengal, India
| | - Srabani Chakrabarti
- Department of Pathology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Mrinal Sikder
- Department of Pathology, Calcutta National Medical College, Kolkata, West Bengal, India
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11
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Bagga R, Kaur J, Suri V, Nijhawan R, Gupta N. To treat or not to treat: Microfilaria detected in Pap smear. Trop Doct 2017; 48:122-123. [PMID: 29141504 DOI: 10.1177/0049475517738411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rashmi Bagga
- 1 Professor, Department of Obstetrics and Gynecology, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Japleen Kaur
- 1 Professor, Department of Obstetrics and Gynecology, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Vikas Suri
- 2 Associate Professor, Department of Internal Medicine, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Raje Nijhawan
- 3 Professor, Department of Cytopathology and Gynecological Pathology, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India.,4 Present address: 2126, Sector 15-D, Chandigarh 160015, India
| | - Nalini Gupta
- 3 Professor, Department of Cytopathology and Gynecological Pathology, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India
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12
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Basu A, Kumar A, Manchanda S, Wig N. Filarial huge splenomegaly dramatically regressed by anti-filarial medication: A rare clinical scenario. Intractable Rare Dis Res 2017; 6:215-218. [PMID: 28944146 PMCID: PMC5608934 DOI: 10.5582/irdr.2017.01041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/25/2017] [Accepted: 08/26/2017] [Indexed: 11/05/2022] Open
Abstract
Lymphatic filariasis is caused by nematodes Wuchereria bancrofti, Brugia malayi and Brugia timori. Lymphatic filariasis is a spectrum of illness and can manifest as, asymptomatic microfilaraemia, acute lymphatic filariasis (lymphangitis and lymphoedema), chronic lymphoedema, elephantiasis, hydrocele, tropical pulmonary eosinophilia and some systemic manifestations which involves joint, heart, kidney, nerve, etc. We here present a case of huge splenomegaly caused by lymphatic filariasis which is a rare presentation and only few cases had been reported in the world literature so far. After treatment of filariasis spleen size was reduced dramatically and patient is doing well even after 6 months of follow up after therapy.
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Affiliation(s)
- Ayan Basu
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Arvind Kumar
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Smita Manchanda
- Department of Radio diagnosis, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Naveet Wig
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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13
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Afrose R, Alam MF, Ahmad SS, Naim M. Filarial abscess: Aspiration of adult gravid female worm from submandibular region, an unusual presentation. J Cytol 2017; 34:66-68. [PMID: 28182103 PMCID: PMC5259939 DOI: 10.4103/0970-9371.197626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Microfilaria is a major public health problem in tropical and subtropical countries and is an endemic problem in India. Wuchereria bancrofti is the most common filarial infection. In some cases, microfilariae and adult filarial worm have been incidentally detected in fine-needle aspirates of various lesions; detection of microfilaria from subcutaneous site or from abscess site is even rarer. We here report an unusual case of Bancroftian microfilariasis in a 68-year-old female coming from endemic area presenting with right submandibular abscess. Our aim is to highlight the chances of finding microfilaria and adult worm in cytology of an unsuspected case at an unusual site.
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Affiliation(s)
- Ruquiya Afrose
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Feroz Alam
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Syed Shamshad Ahmad
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammed Naim
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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14
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Sahoo N, Saha A, Mishra P. Coexistence of microfilaria with metastatic adenocarcinomatous deposit from breast in axillary lymph node cytology: A rare association. J Cytol 2017; 34:43-45. [PMID: 28182075 PMCID: PMC5259929 DOI: 10.4103/0970-9371.197617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Filariasis is a global social health problem of tropical and sub tropical countries like India. W.bancrofti accounts for 95% of cases of lymphatic filariasis. Microfilaria in cytosmears are a rare finding. We report a case of 55 year old female presented with right axillary swelling with ipsilateral breast lump. Cytosmears from the lymph node aspirate showed metastatic adenocarcinomatous deposits and a bunch of microfilariae surrounding the tumor cells and the aspirate from the breast shows ductal carcinoma. We report an additional case of a rare association of microfilaria co-existing with carcinomatous deposit in the lymph node.
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Affiliation(s)
- Nibedita Sahoo
- Department of Pathology, AIIMS, Bhubaneswar, Odisha, India
| | - Arpita Saha
- Department of Pathology, AIIMS, Bhubaneswar, Odisha, India
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15
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Filariasis of Stensen's Duct: An Index Case. Case Rep Otolaryngol 2016; 2016:7646451. [PMID: 27867674 PMCID: PMC5102720 DOI: 10.1155/2016/7646451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 10/13/2016] [Indexed: 12/04/2022] Open
Abstract
Filariasis, a neglected tropical disease, is a global health problem and is endemic to 73 countries including India. It is caused by nematodes of Filariodidea family, namely, W. bancrofti and B. malayi in India, which have a predilection for the lower limbs and testis. We report a never before reported case of filariasis of the main parotid duct in a 25-year-old male that resolved on medical management, exemplifying the importance of maintaining a high index of suspicion and careful examination of cytological smears in endemic countries, allowing for an early diagnosis and treatment, decreasing the morbidity of this debilitating disease.
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16
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Dhanya CSR, Jayaprakash HT. Microfilariae, a Common Parasite in an Unusual Site: A Case Report with Literature Review. J Clin Diagn Res 2016; 10:ED08-9. [PMID: 27190816 DOI: 10.7860/jcdr/2016/16042.7563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 02/15/2016] [Indexed: 11/24/2022]
Abstract
Filariasis is common in tropical countries. Wuchereria bancrofti is the most common parasite which causes lymphatic filariasis in India. This paper reports the finding of microfilariae in cervicovaginal smear of a 61-year-old post menopausal woman with a brief review of literature. There are limited numbers of reports describing the presence of microfilariae in the cervicovaginal smears and even rarely as an incidental finding. It is very important to keep in mind and screen for microfilariae in the non-endemic areas also.
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Affiliation(s)
- C S Rohini Dhanya
- Tutor, Department of Pathology, Dr. B.R. Ambedkar Medical College & Hospital , Bangalore, India
| | - H T Jayaprakash
- Professor and HOD, Department of Pathology, Dr. B.R. Ambedkar Medical College & Hospital , Bangalore, India
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17
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Ahuja M, Pruthi SK, Gupta R, Khare P. Unusual presentation of filariasis as an abscess: A case report. J Cytol 2016; 33:46-8. [PMID: 27011444 PMCID: PMC4782405 DOI: 10.4103/0970-9371.175520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Bancroftian filariasis, a tropical and subtropical disease caused by Wuchereria bancrofti, is transmitted by the culex mosquito. The disease is conventionally diagnosed by the demonstration of microfilaria in peripheral blood smear. Microfilaria and adult filarial worms have been incidentally detected in fine needle aspiration cytology (FNAC) in various locations. The disease may be missed if one is not aware of the possibility, particularly in cases where eosinophilia is absent. Therefore, clinicians and pathologists need to be more vigilant in the endemic zones for early diagnosis and the treatment of filariasis. We report here an unusual case of filariasis in a 17-year-old female with a swelling in the lower part of the left arm on the flexor surface. This highlights the chances of finding microfilaria in cytology of an unsuspected case at an unusual site. This case, in addition, stresses the fact that microfilaria may be associated with an abscess even in the absence of eosinophilia.
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Affiliation(s)
- Mukta Ahuja
- Department of Pathology, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India
| | - Sonam Kumar Pruthi
- Department of Pathology, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India
| | - Renu Gupta
- Department of Pathology, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India
| | - Pratima Khare
- Department of Pathology, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India
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Pandey P, Dixit A, Chandra S, Tanwar A. Cytological diagnosis of bancroftian filariasis presented as a subcutaneous swelling in the cubital fossa: an unusual presentation. Oxf Med Case Reports 2015; 2015:251-3. [PMID: 26634138 PMCID: PMC4664843 DOI: 10.1093/omcr/omv027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/23/2015] [Accepted: 02/26/2015] [Indexed: 11/13/2022] Open
Abstract
Filariasis is a disabling parasitic disease and the prevalence of lymphatic filariasis caused by Wuchereria bancrofti is quite high in India. However, W. bancrofti presenting as a subcutaneous swelling and a demonstration of microfilariae in cytological smears from upper extremity lesions is extremely rare. We report a case of 20-year-old male who presented with a small subcutaneous swelling near medial aspect of the left cubital fossa. The wet mount preparation showed many motile microfilariae. Cytology smears revealed a large number of sheathed microfilariae with the tail tip free of nucleus, identified as W. bancrofti without significant inflammatory cell infiltrate. Indirect ELISA was highly positive for specific recombinant W. bancrofti filarial antigen (WL-L2). The role of cytology cannot be underestimated in clinically unanticipated cases of bancroftian filariasis, especially with the amicrofilaremic state. Filariasis should always be considered in the differential diagnosis during cytological evaluation of any swelling, especially in endemic areas.
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Affiliation(s)
- Pinki Pandey
- Department of Pathology , U.P. Rural Institute of Medical Sciences and Research , Saifai, Uttar Pradesh , India
| | - Alok Dixit
- Department of Pharmacology , U.P. Rural Institute of Medical Sciences and Research , Saifai, Uttar Pradesh , India
| | - Subrat Chandra
- Department of Pathology , RML Institute of Medical Sciences , Lucknow, Uttar Pradesh , India
| | - Aparna Tanwar
- Department of Pathology , Maharishi Markandeshwar Institute of Medical Sciences and Research , Solan, Himachal Pradesh , India
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Khare P, Kala P, Jha A, Chauhan N, Chand P. Incidental Diagnosis of Filariasis in Superficial Location by FNAC: A Retrospective Study of 10 Years. J Clin Diagn Res 2014; 8:FC05-8. [PMID: 25653954 PMCID: PMC4316260 DOI: 10.7860/jcdr/2014/9906.5266] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 09/17/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Filariasis, transmitted by the bite of various species of mosquito, is a common disease of tropical belt of the world. In South East Asia, including India, it is a major public health problem. The parasite is primarily confined to Lymphatic channel or lymph nodes where it can remain viable for more than two decades. The most common presentation of the disease is asymptomatic/ subclinical microfilaremia, Hydrocele, acute adeno-lymphangitis (ADL) and chronic lymphatic disease. However, the disease may rarely present as superficial swellings at unusual sites. Incidental findings of microfilaria on fine needle aspiration cytology in these situations, helps in prompt recognition of the disease. AIM The aim of this retrospective study was to assess the incidental diagnosis of Filariasis on fine needle aspiration cytology (FNAC), done for swellings in superficial locations over last ten years at our institute. MATERIALS AND METHODS This retrospective study was conducted over a period of 10 years from April 2003 to March 2013 on the cases where FNAC was carried out on swellings in superficial locations of the body. Twenty cases of filariasis were diagnosed on routine FNAC material obtained from various superficial sites. Their data was retrieved and analyzed. RESULTS Among the 20 cases diagnosed as filariasis on FNAC, six cases involved lymph nodes, six involved testiculo-scrotal region, three cases of thyroid swelling, soft tissue swelling in three cases and breast lump in two cases. On FNA smears, microfilariae were seen in all 20 cases, eggs in three cases, adult female worm in two cases and adult male worm in one case. Adherence of inflammatory cells and macrophages to microfilariae was noticed in 4 cases. Eosinophilia was present in seven cases. Microfilaremia was present in only three cases. Causative agent was Wuchereria bancrofti in all cases. CONCLUSION Although not so common, filariasis should be considered as one of the differential diagnosis of a superficial swelling particularly if clear fluid is obtained on FNAC. Careful screening of smears plays a significant role in recognition of the disease even in asymptomatic patients.
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Affiliation(s)
- Pratima Khare
- Consultant & Head, Department of Pathology, Dr. B.S. Ambedkar Hospital , New Delhi, India
| | - Pooja Kala
- Senior Resident, Department of Pathology, Dr. B.S. Ambedkar Hospital , New Delhi, India
| | - Aditi Jha
- Senior Resident, Department of Dermatology, Safdarjung Hospital New Delhi, India
| | - Nidhi Chauhan
- Senior Resident, Department of Pathology, Dr. B.S. Ambedkar Hospital , New Delhi, India
| | - Priyanka Chand
- Senior Resident, Department of Pathology, Dr. B.S. Ambedkar Hospital , New Delhi, India
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Bouchery T, Ehrhardt K, Lefoulon E, Hoffmann W, Bain O, Martin C. Differential tissular distribution of Litomosoides sigmodontis microfilariae between microfilaremic and amicrofilaremic mice following experimental infection. Parasite 2014. [PMID: 23193519 PMCID: PMC3671463 DOI: 10.1051/parasite/2012194351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Filariases are caused by onchocercid nematodes that are transmitted by arthropod vectors. More than 180 million people are infected worldwide. Mass drug administration has been set up in many endemic areas to control the parasite burden. Although very successful in limiting microfilarial load, transmission has not been completely interrupted in such areas. A proportion of infected patients with lymphatic filariasis or loiasis are known to be amicrofilaremic, as they do not present microfilariae in their bloodstream despite the presence of adult worms. A mirror status also exists in CBA/Ca mice infected with Litomosoides sigmodontis, the well-established model of filariasis. Using this model, the goal of this study was to determine if the kinetics of blood clearance of microfilariae differed between amicrofilaremic CBA/Ca mice and microfilaremic BALB/c mice. For this purpose, a qPCR approach was devised to detect microfilariae in different tissues, after a controlled inoculation of microfilariae. We showed that the rapid clearance of microfilariae from the pleural cavity or from the bloodstream of CBA/Ca mice was associated with a massive accumulation of first stage larvae in the lungs, liver and spleen.
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Affiliation(s)
- T Bouchery
- UMR 7245 MCAM MNHN CNRS & UMR 7205 OSEB MNHN CNRS, Muséum National d'Histoire Naturelle, Paris Cedex, France
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Affiliation(s)
- Neeraj Dhameja
- *Address correspondence to Neeraj Dhameja, Department of Pathology, Institute of Medical Sciences, BHU, Lanka, Varanasi, Varanasi, UP, India 221005. E-mail:
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Abstract
Filarial involvement of breast is a rare entity. Here is an unusual case of an old lady with right breast lump with axillary lymphadenopathy mimicking breast carcinoma, cytologically diagnosed as filarial mastitis. The patient subsequently received antihelmenthic therapy and showed marked clinical response within few weeks.
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Affiliation(s)
- Mohim Thakur
- General Surgery Department, Maulana Azad Medical College and Associated Lok Nayak, Hospital New Delhi, Delhi, India
| | - Yangshen Lhamo
- Pharmacology Department, Maulana Azad Medical College and Associated Lok Nayak, Hospital New Delhi, Delhi, India
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Abstract
Filariasis is a parasitic infectious disease caused by filarial nematode worms. These worms mainly dwell in subcutaneous tissues and lymphatics of the human host, with a predilection for lower limbs, retroperitoneal tissues, spermatic cord, and epididymis. Oral or perioral involvement of the filarial nematode is rare. This case report describes a filarial abscess in the right submandibular region. Fine needle aspiration cytology of the abscess revealed the presence of microfilaria of Wuchereria bancrofti species. The parasite was also present in the peripheral blood smear. Filarial infection presenting in this region is unusual and can cause diagnostic dilemma. The clinician can consider filariasis as one of the differential diagnosis while treating those abscesses in the orofacial region that are unresponsive to routine management, especially, patients hailing from endemic areas.
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Affiliation(s)
- Rupinder Kaur
- Department of Pathology, Christian Medical College and Hospital, Ludhiana, Punjab, India
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24
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Tandon N, Bansal C, Sharma R, Irfan S. Role of fine needle aspiration cytology in diagnosing filarial arm cysts. BMJ Case Rep 2013; 2013:bcr2013009677. [PMID: 23687368 PMCID: PMC3669882 DOI: 10.1136/bcr-2013-009677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes: Wuchereria bancrofti and Brugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology and peripheral blood findings. FNA provides definitive diagnosis and is an important tool for diagnosing soft tissue swellings owing to filariasis.
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Affiliation(s)
- Nishi Tandon
- Department of Pathology, Era Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Cherry Bansal
- Department of Pathology, CSMMU, Lucknow, Uttar Pradesh, India
| | - Richa Sharma
- Department of Pathology, Era Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Sumaiya Irfan
- Department of Pathology, Era Medical College and Hospital, Lucknow, Uttar Pradesh, India
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Pantola C, Kala S, Agarwal A, Khan L. Microfilaria in cytological smears at rare sites coexisting with unusual pathology: A series of seven cases. Trop Parasitol 2013; 2:61-3. [PMID: 23508347 PMCID: PMC3593499 DOI: 10.4103/2229-5070.97244] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 06/16/2012] [Indexed: 11/04/2022] Open
Abstract
Filariasis is a major public health problem in India and microfilaria is sometimes seen during routine fine needle aspiration cytology (FNAC) smears, but it is very rare to find microfilaria coexistent with neoplastic lesions. Here we report a series of seven cases in which microfilaria is associated with neoplastic lesions. Out of these seven cases one is benign and six are malignant. Also we first time report the microfilaria coexistent with parotid pleomorphic adenoma, undifferentiated carcinoma thyroid and gall bladder carcinoma.
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Affiliation(s)
- Chayanika Pantola
- Department of Pathology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
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Cytological diagnosis of parasites presenting as superficial nodular swelling: report of 35 cases. J Parasit Dis 2013; 36:106-11. [PMID: 23542395 DOI: 10.1007/s12639-011-0095-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 12/28/2011] [Indexed: 10/14/2022] Open
Abstract
Parasitic infestation often present with superficial nodular swelling. Fine needle aspiration cytology plays an important role in prompt diagnosis of the disease. To study the role of FNAC in the diagnosis of parasites presenting as skin or subcutaneous nodules. Total 361 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. Out of the 361 cases, 35 cases were diagnosed as suggestive of parasitic infestation. These 35 cases form the study group. In 14 cases out of 35 cases, a definitive diagnosis of parasitic infestation was made as parasite or fragments of parasite were seen in the aspirate. In 21 cases, neither parasite nor fragments could be identified on the aspirates and a diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings. In 17 of these cases, a biopsy correlation was available, which revealed definitive parasite in 8 cases and the remaining 9 were reported as suggestive of parasitic cyst. The cytological diagnosis was confirmatory in cases where the parasite fragment were identified in the smears. However, in other cases, clear aspirate, presence of eosinophils, macrophages and typical granular dirty background are the features which should prompt the cytologist to the possibility of parasitic infestation.
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Udare A, Mahajan A, Thakur M, Medhi S, Ramani S. A rare demonstration of the filarial dance sign in the upper limb lymphatic vessels mimicking deep venous thrombosis. JOURNAL OF ULTRASOUND IN MEDICINE 2012; 31:1464-5. [PMID: 22922628 DOI: 10.7863/jum.2012.31.9.1464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
Besides peripheral blood smears, microfilariae have been described in aspirate smears from different sites. Identification of microfilariae in the chylous urine of otherwise asymptomatic filarial patients has been rarely described. One such case is presented.
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Affiliation(s)
- Ankit Seth
- Department of Pathology, Kasturba Hospital, Daryaganj, Delhi, India
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29
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Vaid SJ, Luthra A, Karnik S, Ahuja AT. Facial wrigglies: live extralymphatic filarial infestation in subcutaneous tissues of the head and neck. Br J Radiol 2011; 84:e126-9. [PMID: 21606067 DOI: 10.1259/bjr/84379927] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report a rare case of a 32-year-old male with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling. To the best of our knowledge these imaging findings have not been previously reported in the head and neck region in the existing English language literature. Real-time high-resolution ultrasonography revealed a solitary well-defined subcutaneous cystic lesion over the right zygomatic arch. It showed multiple linear, echogenic, undulating structures exhibiting a persistent twirling motion during the examination. This typical ultrasonographic appearance was consistent with the filarial dance sign (FDS) of live adult filarial worms. Subsequent MRI confirmed the cystic and solitary nature of the lesion. Complete excision of the cyst was performed, which revealed intracystic straw-coloured fluid and multiple white-coloured adult worms within the lesion. Histopathological examination confirmed multiple adult filarial worms with surrounding reactive inflammatory changes. In an endemic region, identification of the FDS in any normal anatomical structure or abnormal swelling, however remote or unusual the location within the body, should strongly suggest the diagnosis of live active filarial infestation. In view of the increasing migratory trends in the global population, it is imperative for radiologists in all countries to be aware of the typical imaging findings of this disease to arrive at the correct diagnosis.
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Affiliation(s)
- S J Vaid
- Department of Radiology and Imaging, Grant Medical Foundation, Maharashtra, India.
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Singh P, Anshu, Gangane N. Cytological diagnosis of filarial infection in an endemic area where screening and prophylaxis is in place. Cytopathology 2011; 23:325-9. [PMID: 21733001 DOI: 10.1111/j.1365-2303.2011.00890.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Filariasis has a worldwide distribution. However, the disease is often overlooked or misdiagnosed because of its unusual presentations and there may be false-negative results in endemic areas. This study was carried out to assess the role of cytology in the demonstration of filarial parasites in an area where screening and prophylaxis are in place. METHODS This study was carried out in Wardha district in central India, which is endemic for filarial infection. A total of 9182 smears of cases undergoing cytological evaluation were routinely screened at the time of reporting for the presence of adult filarial worm, microfilarial larvae or their fertilized and unfertilized eggs, irrespective of their original clinical diagnosis. RESULTS Microfilariae were found incidentally in fine needle aspiration (FNA) smears of patients presenting with other clinical conditions. Smears of seven cases were found to be positive for microfilaria. Four cases presented with subcutaneous nodules in the upper arm, two cases were seen incidentally in axillary lymph node aspirates and microfilariae were found in the pleural fluid in one case. Another case was suspected to have breast cancer, but aspirates from the axillary area showed lymphatic obstruction considered to be due to filariasis. CONCLUSION FNA cytology is an inexpensive, simple and easy procedure for detecting microfilariae. Detection of microfilariae may not be common even in endemic areas as screening and prophylaxis is routinely performed, and patients may show atypical presentations such as subcutaneous nodules. We believe that careful screening of FNAs, especially those from subcutaneous swellings, as well as serous fluids, is very important in a filariasis-endemic zone.
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Affiliation(s)
- P Singh
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India
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31
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Vij M, Kumari N, Krishnani N. Microfilaria in liver aspiration cytology: an extremely rare finding. Diagn Cytopathol 2011; 39:521-2. [PMID: 21695804 DOI: 10.1002/dc.21483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 06/03/2010] [Indexed: 11/06/2022]
Abstract
Filariasis is a common public health problem in the Indian subcontinent. The diagnosis can be made conventionally by demonstrating microfilaria in peripheral blood smears. Despite its high incidence it is unusual to find microfilariae in fine-needle aspiration (FNA) cytology smears. Microfilariae have been reported in cytological specimens of various organs, but it is extremely rare to find microfilaria in fine FNA cytology of liver. We report seventh case of microfilaria in liver aspirate in a male patient suffering from gallbladder cancer.
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Affiliation(s)
- Mukul Vij
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Utter Pradesh, India
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Rekhi B, Kane SV. Microfilariae coexisting with a follicular lesion in thyroid aspirate smears in an uncommon case of a retrosternal thyroid mass, clinically presenting as malignancy. Cytojournal 2011; 8:4. [PMID: 21383959 PMCID: PMC3049240 DOI: 10.4103/1742-6413.76732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 09/20/2010] [Indexed: 01/21/2023] Open
Affiliation(s)
- Bharat Rekhi
- Department of Pathology, Department of Cytopathology, Tata Memorial Hospital, Parel, Mumbai, India
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Gupta S, Gupta R, Bansal B, Singh S, Gupta K, Kudesia M. Significance of incidental detection of filariasis on aspiration smears: a case series. Diagn Cytopathol 2010; 38:517-20. [PMID: 19941370 DOI: 10.1002/dc.21264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Filariasis is a major public health problem in tropical and subtropical countries including India. Although there are reports of incidentally diagnosed cases of lymphatic filariasis in the existing literature, the significance of this finding needs to be summarised in one place. The association of filariasis with neoplasms is still debatable. For this series, cases diagnosed as filariasis on aspiration cytology (with or without coexistent pathology) over a period of 1 year were retrieved. The cases with a clinical suspicion of filariasis were excluded. Hence, five cases with incidental diagnosis of filariasis on aspiration cytology were included. The site of aspiration included one case each of thyroid, breast, bone marrow, cervical lymph node, and subcutaneous nodule. Of these, three cases showed microfilariae, one showed only adult female worm while one showed both microfilariae and adult worm. Two cases did not show any inflammatory response while three cases showed a variable inflammatory reaction. Only one case (thyroid aspirate) had a coexistent pathology (colloid goitre). Filariasis may be detected in a clinically unsuspected case, especially in an endemic zone. The spectrum of host response may vary from no reaction to a marked inflammatory response. The entire spectrum of changes should be kept in mind while practicing cytopathology in an endemic area. In such situations, a high index of suspicion and careful screening of cytology smears are keys to a correct diagnosis. At the same time, keen search for a coexisting pathology, benign or malignant, is also mandatory.
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Affiliation(s)
- Sampada Gupta
- Department of Pathology, Hindu Rao Hospital, New Delhi, India
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Kaur R, Phillip KJ, Masih K, Kapoor R, Johnny C. Filariasis of the Breast Mimicking Inflammatory Carcinoma. Lab Med 2009. [DOI: 10.1309/lm8jj0pbb7riwnlb] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Dwivedi RC, Gupta P, Dwivedi RC, Kishore K, Bhatia N. Lymphadenovarix of the head-neck region--a rare presentation of Bancroftian filariasis. J Trop Pediatr 2009; 55:332-4. [PMID: 19095694 DOI: 10.1093/tropej/fmn111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cystic swellings of the neck in children have limited differential diagnoses, often either lymphatic or vascular malformations. Other cystic inflammations can be the result of tuberculous abscesses, suppurated lymph nodes and actinomycosis. Microfilaria causing lmphadenovarix of head-neck region has not yet been described in the literature. A 10-year-old Indian boy presented with an asymptomatic cystic neck mass of 8 months duration. Aspiration of the swelling demonstrated numerous Wuchereria bancrofti microfilaria and the patient responded well to 6 weeks of daily anti-filarial treatment using diethylcarbamazine citrate (6mg kg(-1) day(-1)). This appears to be the first report of microfilariae-associated lymphadenovarix of head-neck region. Though rare, filariasis should be considered as a differential diagnosis for aberrant swellings where lymphatic filarids are endemic.
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36
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Rawat V, Rizvi G, Sharma N, Pandey H. An unusual presentation of Wuchereria bancrofti infection. Indian J Med Microbiol 2009; 27:382-3. [PMID: 19736421 DOI: 10.4103/0255-0857.55442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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37
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Zafar U, Rahman K, Sherwani RK, Shahid M. Microfilariae of Wucheria bancrofti in bone marrow. Indian J Hematol Blood Transfus 2009; 25:42-3. [PMID: 23100973 PMCID: PMC3453482 DOI: 10.1007/s12288-009-0011-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 03/14/2009] [Indexed: 10/20/2022] Open
Affiliation(s)
- Uzma Zafar
- Department of Pathology, J.N.M.C.H, A.M.U., Aligarh, 202 002 India
| | - Khaliqur Rahman
- Department of Pathology, J.N.M.C.H, A.M.U., Aligarh, 202 002 India
| | - Rana K. Sherwani
- Department of Pathology, J.N.M.C.H, A.M.U., Aligarh, 202 002 India
| | - Mohammad Shahid
- Department of Pathology, J.N.M.C.H, A.M.U., Aligarh, 202 002 India
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38
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Mitra SK, Mishra RK, Verma P. Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh. J Cytol 2009; 26:11-4. [PMID: 21938142 PMCID: PMC3167983 DOI: 10.4103/0970-9371.51333] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Filariasis is a major health problem in tropical countries including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. AIM To assess the role of fine needle aspiration cytology (FNAC) in diagnosis of filariasis at all possible sites. MATERIALS AND METHODS Total 250 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. RESULTS Out of 250 cases, 24 cases of filariasis were detected which include breast lumps (8 cases), lymph nodes (6 cases), scrotal swellings (4 cases), thyroid swellings (3 cases), soft tissue swellings (2 cases) and ascitic fluid (1 case). Eosinophilia was present in 8 out of 24 cases with a percentage ranging from 12-24%. Significant adherence of inflammatory cells and macrophages to microfilariae was present in 3 out of 24 cases. CONCLUSIONS In endemic areas, it should be considered one of the differential diagnoses of a superficial swelling. Careful screening of FNAC smears help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment.
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Affiliation(s)
- Shaila K Mitra
- Department of Pathology, BRD Medical College, Gorakhpur, India
| | - Rajiv K Mishra
- Department of Pathology, BRD Medical College, Gorakhpur, India
| | - Pallavi Verma
- Department of Pathology, BRD Medical College, Gorakhpur, India
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39
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Maheshwari V, Khan L, Mehdi G, Zafar U, Alam K. Microfilariae in thyroid aspiration smear--an unexpected finding. Diagn Cytopathol 2007; 36:40-1. [PMID: 18064692 DOI: 10.1002/dc.20549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Lymphatic filariasis is a major health problem in tropical countries including India. Despite its high incidence it is difficult to find microfilariae in blood and fine-needle aspirates due to the nocturnal periodicity of species endemic in India. Lymphatic filariasis can manifest as asymptomatic microfilaremia, hydrocele, lymphangitis, and lymphadenitis. The presence of microfilariae in thyroid aspirates is a rare finding. A case of microfilariae in a thyroid aspirate is being reported to emphasize the significance of careful screening of smears in endemic areas.
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Affiliation(s)
- Veena Maheshwari
- Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Basu A, Sistla SC, Verma SK, Jagdish S. Lymphadenovarix in the axilla--an unusual presentation of filariasis. FILARIA JOURNAL 2006; 5:9. [PMID: 16875505 PMCID: PMC1552058 DOI: 10.1186/1475-2883-5-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2004] [Accepted: 07/30/2006] [Indexed: 11/10/2022]
Abstract
Clinical manifestations of lymphatic filariasis depend on the area of lymphatic involvement and the duration of infection. A 21 year old man, resident in a filariasis endemic region, presented with multiple matted lymph nodes with cystic areas forming a large mass in his left axilla. An ultrasound scan of the axilla using a 7.5 MHz transducer revealed grossly dilated lymphatics but no filarial dance sign. Fine needle (21 G) aspiration cytology (FNAC) from the dilated lymphatics and solid areas in the lymph node mass revealed multiple microfilariae in a background of reactive lymphoid cells. Peripheral blood smears revealed microfilaremia with significant eosinophilia. Diagnosis of left axillary Bancroftian lymphadenovarix was made. On the administration of oral diethylcarbamazine, the diameter of the lymphatic vessels in the lymphadenovarix reduced considerably in size and microfilaremia disappeared. We report this case because axillary lymphadenovarix is a rare presentation of filariasis. This case is also unique since microfilariae were demonstrated in the fluid aspirated from the dilated lymphatics of the lymphadenovarix in the absence of live adult worms.
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Affiliation(s)
- Adhish Basu
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Sarath Chandra Sistla
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Surendra Kumar Verma
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - S Jagdish
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Bagla N, Patel MM, Pandya AN, Thakral C. Microfilariae in cytology smears: real culprits or trapped accidentally by needles? A study of 10 cases. Cytopathology 2005; 16:316-7. [PMID: 16303048 DOI: 10.1111/j.1365-2303.2005.00281.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The clinical presentation, investigation and treatment of women with breast lumps are greatly influenced by geographical factors. These impact disease patterns and their presentation (e.g. socioeconomic/educational status and cultural/religious beliefs) and the availability of specialist health care personnel and facilities. The differential diagnoses of a breast lump include breast cancer, benign solid and cystic lumps and inflammatory conditions. The likelihood of a diagnosis relates more to geographical area, age, ethnic origin, family history of breast cancer, presence of high-risk pathology, endemic infection, smoking, pregnancy and lactation history, puerperal care and health education. Investigations and treatments vary more according to the availability of expertise and facilities (e.g. combined diagnostic clinic staffed by breast surgeon and radiologist; breast radiologist to carry out image-guided diagnostic and therapeutic procedures). This article discusses the clinical assessment and investigation of breast lumps and possible treatments from an Asia Pacific perspective.
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Affiliation(s)
- Kwok Leung Cheung
- Professorial Unit of Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, U.K.
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Khanna S, Uniyal B. Ascites secondary to metastatic gall bladder cancer and filariasis. J Gastroenterol Hepatol 2004; 19:1427-8. [PMID: 15610323 DOI: 10.1111/j.1440-1746.2004.03614.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Affiliation(s)
- Anup Kumar Kundu
- Department of Surgery, North Bengal Medical College & Hospital, Sushrutnagar, Darjeeling, India
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Aron M, Kapila K, Sarkar C, Verma K. Microfilariae of Wuchereria bancrofti in cyst fluid of tumors of the brain: a report of three cases. Diagn Cytopathol 2002; 26:158-62. [PMID: 11892020 DOI: 10.1002/dc.10074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Microfilariae of various nematodes, including Loa loa, Dirofilariae, and Onchocerca volvulus, have been identified in the central nervous system (CNS). The CNS, however, is a rare site for the isolation of microfilariae of Wuchereria bancrofti. To the best of our knowledge, the presence of microfilariae of W. bancrofti in tumor cyst fluids or cerebrospinal fluid has not been reported to date. We report three cases in which microfilariae were identified in the cyst fluid of tumors of the brain. Cyst fluid aspirated from space-occupying lesions in the thalamus and C6-D1 spinal segments in a 46-yr-old man and a 35-yr-old man, respectively, showed numerous microfilariae of W. bancrofti, along with fragments of tumor suggestive of glioma. In the third case, in a 12-yr-old boy, the fluid from the space-occupying lesion in the third ventricle showed microfilariae in a necrotic dirty background with a few squames and cholesteral crystals. Histopathologic examination of the tumor showed an anaplastic astrocytoma and a low-grade astrocytoma in the first two cases, respectively, and a craniopharyngioma in the third case. No microfilariae were identified on the histology sections.
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Affiliation(s)
- Manju Aron
- Cytology Laboratory, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Lam KY, Tong AC, Chan SK. Intraoral filarial infestation: an atypical presentation. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 92:481-3. [PMID: 11709679 DOI: 10.1067/moe.2001.118476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Bernhard P, Makunde RW, Magnussen P, Lemnge MM. Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania. Trans R Soc Trop Med Hyg 2000; 94:409-12. [PMID: 11127246 DOI: 10.1016/s0035-9203(00)90123-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To assess the significance of lymphatic filariasis for the development of chronic genital manifestations and for reproductive health in women, we conducted a cross-sectional study of 2 villages in north-eastern Tanzania including interview and gynaecological examination of adult women, focusing primarily on reproductive history and genital health. In a population of 2165 residents, prevalence of Wuchereria bancrofti microfilaraemia was 28%, and geometric mean intensity of microfilariae (mf) was 722 mf/mL. Leg lymphoedema (elephantiasis) was present in 4.2% of adults aged > or = 15 years, and hydrocoele in 26.5% of adult males. Five hundred and thirty women completed an interview, and 404 of these completed a gynaecological examination. Most women were Muslims (72%), polygamy was common (29%), and 49% of women had undergone circumcision (clitoridectomy). Presence of microfilaraemia did not influence fertility or fertility-related variables including age at menarche, parity, spontaneous abortion, stillbirth, Caesarean section and premature labour, nor presence of primary or secondary infertility. Mf status was strongly correlated with abnormal menstruation pattern in the 30+ years age-group (P = 0.001), but not in the < 30 years age-group. Cervical, vaginal and vulval pathology was unrelated to mf status. Two women, aged 46 and 77 years, had vulval oedema of probable filarial origin, both were mf negative. Overall, microfilaraemia appeared to have no influence on genital disease or reproductive health, and chronic manifestations of lymphatic filariasis of the genitals does not appear to be a substantial problem in women.
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Affiliation(s)
- P Bernhard
- Danish Bilharziasis Laboratory, Jaegersborg Alle 1 D, DK-2920 Charlottenlund, Denmark.
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