Prasoon Dev, Agrawal Parimal
Dr. Prasoon's Diagnostic Centre, Munger, Bihar, India.
J Cytol. 2020 Oct-Dec;37(4):182-188. doi: 10.4103/JOC.JOC_59_20. Epub 2020 Sep 16.
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.
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.
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.
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.
吴策线虫病是慢性发病的一个重要原因。它可影响身体的任何器官/组织。细针穿刺细胞学检查（FNAC）是一种用于其检测的简便方法。任何出版物均未对所涉及的各个方面进行详细的综合分析。
对所有经细胞学诊断为吴策线虫病的患者进行了为期26年（1994年2月至2020年1月）的回顾性审计。记录了有关年龄、性别、受累器官/组织以及并存疾病情况的数据。对苏木精和伊红（H&E）染色及吉姆萨染色的玻片进行检查，以查找微丝蚴、成虫、幼虫形态、微丝蚴残迹、上皮样细胞肉芽肿和嗜酸性粒细胞。
审计共得到19323例病例，其中110例患有吴策线虫病，发病率为0.57%。11至30岁年龄组占病例的41.8%。男女比例为1.04:1。就诊时疾病持续时间从3天到24年不等。淋巴结是最常受累的部位（40%），其次是软组织（23.6%）和女性乳房（14.5%）。女性乳房穿刺物中的寄生虫负荷最高。105例（95.4%）病例中可见班氏微丝蚴。在未发现班氏微丝蚴的5例病例中，通过存在成熟雌虫（2例）、卷曲幼虫（2例）以及成熟雌虫和卷曲幼虫均存在（1例）来确诊。18.2%的病例中可见微丝蚴残迹。分别有17.3%和13.6%的病例存在并存的良性和恶性疾病。
FNAC提供了一种检测吴策线虫病的简单且廉价的方法，优于组织病理学检查。在细胞学检查中可识别该线虫在人体内的所有发育阶段。微丝蚴残迹是筛查中的有用线索。肉芽肿和嗜酸性粒细胞浸润的存在仅表明组织反应。无症状微丝蚴血症患者在细胞学检查中应予以报告，因为他们需要治疗。
