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

Pandey P, Dixit A, Chandra S, Tanwar A - Oxf Med Case Reports (2015)

Bottom Line: Filariasis is a disabling parasitic disease and the prevalence of lymphatic filariasis caused by Wuchereria bancrofti is quite high in India.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology , U.P. Rural Institute of Medical Sciences and Research , Saifai, Uttar Pradesh , India.

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.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph of a sheathed microfilaria of W. bancrofti with a clear space free of nuclei at the caudal end (May Grunwald Giemsa, ×400).
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OMV027F3: Photomicrograph of a sheathed microfilaria of W. bancrofti with a clear space free of nuclei at the caudal end (May Grunwald Giemsa, ×400).

Mentions: The wet mount preparation showed many motile microfilariae (Fig. 2). Cytology smears revealed a large number of microfilariae, identified as W. bancrofti because of the presence of hyaline sheath and cephalic space length : breadth ratio was 1 : 1; nuclei were almost spherical, regularly placed, appeared in regular row, well separated without any overlapping and were absent at the tip tail, without significant inflammatory cell infiltrate (Fig. 3). With the cytomorphological diagnosis of subcutaneous filariasis, the patient had nocturnal blood examination, but no microfilariae were found on three consecutive nights. Patient's routine hematological including blood eosinophil counts (3%) and biochemical investigations were also within normal limits. Indirect ELISA was performed which was highly positive for specific recombinant W. bancrofti filarial antigen (WL-L2). Swelling subsided after administration of diethylcarbamazine (100 mg three times a day) for 21 days.Figure 2:


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

Pandey P, Dixit A, Chandra S, Tanwar A - Oxf Med Case Reports (2015)

Photomicrograph of a sheathed microfilaria of W. bancrofti with a clear space free of nuclei at the caudal end (May Grunwald Giemsa, ×400).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664843&req=5

OMV027F3: Photomicrograph of a sheathed microfilaria of W. bancrofti with a clear space free of nuclei at the caudal end (May Grunwald Giemsa, ×400).
Mentions: The wet mount preparation showed many motile microfilariae (Fig. 2). Cytology smears revealed a large number of microfilariae, identified as W. bancrofti because of the presence of hyaline sheath and cephalic space length : breadth ratio was 1 : 1; nuclei were almost spherical, regularly placed, appeared in regular row, well separated without any overlapping and were absent at the tip tail, without significant inflammatory cell infiltrate (Fig. 3). With the cytomorphological diagnosis of subcutaneous filariasis, the patient had nocturnal blood examination, but no microfilariae were found on three consecutive nights. Patient's routine hematological including blood eosinophil counts (3%) and biochemical investigations were also within normal limits. Indirect ELISA was performed which was highly positive for specific recombinant W. bancrofti filarial antigen (WL-L2). Swelling subsided after administration of diethylcarbamazine (100 mg three times a day) for 21 days.Figure 2:

Bottom Line: Filariasis is a disabling parasitic disease and the prevalence of lymphatic filariasis caused by Wuchereria bancrofti is quite high in India.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology , U.P. Rural Institute of Medical Sciences and Research , Saifai, Uttar Pradesh , India.

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.

No MeSH data available.


Related in: MedlinePlus