Sahu Priya, Gupta Prajwala, Bhardwaj Minakshi, Durga C K
Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, NEW DELHI, INDIA.
Turk Patoloji Derg. 2020;36(1):87-89. doi: 10.5146/tjpath.2018.01423.
Filariasis is a major public health problem in tropical countries like India. Despite the large number of people at risk, detection of eggs with or without larva (microfilaria) on fine-needle aspiration cytology is very unusual, especially in an uncommon site or incidentally detected in clinically unsuspected cases of filariasis with the absence of microfilariae in the peripheral blood. A 19-year-old male presented with swelling over medial aspect of left arm (just above the elbow), with no other specific signs and symptoms. Fine needle aspiration cytology revealed an adult gravid female filarial worm in a background of reactive lymphoid cells and lymphohistiocytic clusters. We report a case with elaborate fine needle aspiration cytology findings of filarial worm infestation with unusual presentation of isolated epitrochlear lymph node involvement in a clinically unsuspected case and recommend clinicians and pathologists to consider a high index of suspicion for such infections at uncommon sites especially in endemic territories, as early diagnosis and treatment prevent the more severe manifestations of disease.
丝虫病在印度等热带国家是一个主要的公共卫生问题。尽管有大量人群面临风险，但在细针穿刺细胞学检查中发现带有或不带有幼虫（微丝蚴）的虫卵非常罕见，尤其是在不常见的部位，或者在临床上未被怀疑患有丝虫病且外周血中无微丝蚴的病例中偶然发现。一名19岁男性因左臂内侧（肘部上方）肿胀就诊，无其他特异性体征和症状。细针穿刺细胞学检查显示在反应性淋巴细胞和淋巴组织细胞簇背景中有一条成年妊娠雌性丝虫。我们报告了一例病例，其细针穿刺细胞学检查结果详细显示了丝虫感染，该病例表现不寻常，在临床上未被怀疑的情况下出现孤立的滑车上淋巴结受累，建议临床医生和病理学家在不常见部位，尤其是在流行地区，对这类感染保持高度怀疑指数，因为早期诊断和治疗可预防疾病的更严重表现。
