Nanda Annu, Gupta Nidhi, Lamba Sangeeta, Sethi Divya
Department of Pathology, ESI Hospital, Rohini, Delhi, India.
Trop Parasitol. 2018 Jul-Dec;8(2):121-123. doi: 10.4103/tp.TP_60_17. Epub 2018 Dec 27.
Detection of adult gravid filarial worm in fine-needle aspiration cytology (FNAC) smears is unusual despite the high incidence of this parasite in endemic zones. Bancroftian filariasis presenting as subcutaneous nodules is very rare, and only a few cases are reported in literature. In spite of various reports stating the presence of microfilaria using aspiration cytology in various sites, the presence of an adult gravid filarial worm in subcutaneous nodules by FNAC is an extremely rare finding. We hereby report an unusual case of detection of adult gravid worm of on FNAC of a subcutaneous nodule in the axilla. In differential diagnosis of subcutaneous nodular swellings, a possibility of filariasis must be kept in mind, and a careful search should be done for the adult worm or microfilaria in the aspiration smears done for an accurate diagnosis. The conventional method of diagnosis of filariasis is by demonstration of microfilaria in the peripheral blood smear which may be diurnal or nocturnal. Buffy coat can be helpful in detecting microfilaria in asymptomatic cases with peripheral blood eosinophilia.
尽管在流行地区这种寄生虫的发病率很高，但在细针穿刺细胞学检查（FNAC）涂片中检测到成年妊娠丝虫并不常见。班氏丝虫病表现为皮下结节非常罕见，文献中仅报道了少数病例。尽管有各种报告称在不同部位使用穿刺细胞学检查发现了微丝蚴，但通过FNAC在皮下结节中发现成年妊娠丝虫是极其罕见的发现。我们在此报告一例罕见病例，在腋窝皮下结节的FNAC中检测到成年妊娠丝虫。在皮下结节性肿胀的鉴别诊断中，必须考虑丝虫病的可能性，并且应在为准确诊断而进行的穿刺涂片中仔细寻找成虫或微丝蚴。丝虫病的传统诊断方法是通过在外周血涂片中发现微丝蚴，微丝蚴可能是昼现的或夜现的。血沉棕黄层有助于在无症状外周血嗜酸性粒细胞增多的病例中检测微丝蚴。
