Lymphatic filariasis: Aspiration of adult gravid female worm from a soft tissue swelling
Identifieur interne : 002570 ( Pmc/Corpus ); précédent : 002569; suivant : 002571Lymphatic filariasis: Aspiration of adult gravid female worm from a soft tissue swelling
Auteurs : Kalpana Azad ; Rashmi Arora ; Kusum Gupta ; Uma SharmaSource :
- Journal of Cytology / Indian Academy of Cytologists [ 0970-9371 ] ; 2010.
Url:
DOI: 10.4103/0970-9371.73308
PubMed: 21157572
PubMed Central: 3001208
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lymphatic filariasis: Aspiration of adult gravid female worm from a soft tissue swelling</title><author><name sortKey="Azad, Kalpana" sort="Azad, Kalpana" uniqKey="Azad K" first="Kalpana" last="Azad">Kalpana Azad</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Arora, Rashmi" sort="Arora, Rashmi" uniqKey="Arora R" first="Rashmi" last="Arora">Rashmi Arora</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gupta, Kusum" sort="Gupta, Kusum" uniqKey="Gupta K" first="Kusum" last="Gupta">Kusum Gupta</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Sharma, Uma" sort="Sharma, Uma" uniqKey="Sharma U" first="Uma" last="Sharma">Uma Sharma</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21157572</idno><idno type="pmc">3001208</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001208</idno><idno type="RBID">PMC:3001208</idno><idno type="doi">10.4103/0970-9371.73308</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">002570</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002570</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Lymphatic filariasis: Aspiration of adult gravid female worm from a soft tissue swelling</title><author><name sortKey="Azad, Kalpana" sort="Azad, Kalpana" uniqKey="Azad K" first="Kalpana" last="Azad">Kalpana Azad</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Arora, Rashmi" sort="Arora, Rashmi" uniqKey="Arora R" first="Rashmi" last="Arora">Rashmi Arora</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gupta, Kusum" sort="Gupta, Kusum" uniqKey="Gupta K" first="Kusum" last="Gupta">Kusum Gupta</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Sharma, Uma" sort="Sharma, Uma" uniqKey="Sharma U" first="Uma" last="Sharma">Uma Sharma</name><affiliation><nlm:aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Cytology / Indian Academy of Cytologists</title><idno type="ISSN">0970-9371</idno><idno type="eISSN">0974-5165</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kapila, K" uniqKey="Kapila K">K Kapila</name></author><author><name sortKey="Verma, K" uniqKey="Verma K">K Verma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garbyal, Rs" uniqKey="Garbyal R">RS Garbyal</name></author><author><name sortKey="Arundhati" uniqKey="Arundhati">Arundhati</name></author><author><name sortKey="Bohra, A" uniqKey="Bohra A">A Bohra</name></author><author><name sortKey="Bhujan, Kh" uniqKey="Bhujan K">KH Bhujan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pandit, Aa" uniqKey="Pandit A">AA Pandit</name></author><author><name sortKey="Shah, Rk" uniqKey="Shah R">RK Shah</name></author><author><name sortKey="Shenoy, Sg" uniqKey="Shenoy S">SG Shenoy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mitra, Sk" uniqKey="Mitra S">SK Mitra</name></author><author><name sortKey="Mishra, Rk" uniqKey="Mishra R">RK Mishra</name></author><author><name sortKey="Verma, P" uniqKey="Verma P">P Verma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arora, Vk" uniqKey="Arora V">VK Arora</name></author><author><name sortKey="Sen, B" uniqKey="Sen B">B Sen</name></author><author><name sortKey="Dev, G" uniqKey="Dev G">G Dev</name></author><author><name sortKey="Bhatia, A" uniqKey="Bhatia A">A Bhatia</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Cytol</journal-id><journal-id journal-id-type="publisher-id">JCytol</journal-id><journal-title-group><journal-title>Journal of Cytology / Indian Academy of Cytologists</journal-title></journal-title-group><issn pub-type="ppub">0970-9371</issn><issn pub-type="epub">0974-5165</issn><publisher><publisher-name>Medknow Publications</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21157572</article-id><article-id pub-id-type="pmc">3001208</article-id><article-id pub-id-type="publisher-id">JCytol-27-156</article-id><article-id pub-id-type="doi">10.4103/0970-9371.73308</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letters to Editor</subject></subj-group></article-categories><title-group><article-title>Lymphatic filariasis: Aspiration of adult gravid female worm from a soft tissue swelling</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Azad</surname><given-names>Kalpana</given-names></name><xref ref-type="aff" rid="AF0001"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Arora</surname><given-names>Rashmi</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Gupta</surname><given-names>Kusum</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Sharma</surname><given-names>Uma</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib></contrib-group><aff id="AF0001">Department of Pathology, V.M.M.C. and Safdarjung Hospital, New Delhi, India</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Dr. Kalpana Azad, Flat No-74D, Block-D2A, Janak Puri New Delhi - 110 058, India. E-mail: <email xlink:href="kalpanaazad@rediffmail.com">kalpanaazad@rediffmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2010</year></pub-date><volume>27</volume><issue>4</issue><fpage>156</fpage><lpage>157</lpage><permissions><copyright-statement>© Journal of Cytology</copyright-statement><copyright-year>2010</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions></article-meta></front><body><p>Sir,</p><p>A 35 year-old male resident of Bihar, presented with a soft tissue swelling along the medial aspect of right arm, measuring 2 cm in diameter, of 4 months duration, associated with local pain. He had low grade fever since 2 months and his routine hemogram was normal. His erythrocyte sedimentation rate (ESR) was 64 mm at the end of 1 hour. Clinical diagnosis of tuberculosis was made.</p><p>Fine needle aspiration cytology (FNAC) from the nodule yielded fluid along with a creamy white thread. Smears showed adult gravid female filarial worm having an intact outer cuticle layer and body cavity containing paired uteri filled with different stages of developing microfilariae. Also, few microfilariae were seen protruding out from the breach in the cuticle layer [<xref ref-type="fig" rid="F0001">Figure 1</xref>]. In addition, numerous embryos and coiled larvae [<xref ref-type="fig" rid="F0002">Figure 2</xref>] and fully straightened larvae of <italic>Wuchereria bancrofti</italic> which were sheathed and had no nuclei in the tail end were seen. The background was composed of inflammatory cells including neutrophils, lymphocytes, macrophages and eosinophils.</p><fig id="F0001" position="float"><label>Figure 1</label><caption><p>Adult gravid female worm with numerous microfilariae (Giemsa, ×40)</p></caption><graphic xlink:href="JCytol-27-156-g001"></graphic></fig><fig id="F0002" position="float"><label>Figure 2</label><caption><p>(a) Embryonated eggs and coiled microfilariae (Giemsa, ×100), (b) coiled microfilariae (Giemsa, ×100)</p></caption><graphic xlink:href="JCytol-27-156-g002"></graphic></fig><p>The patient was then treated with oral diethylcarbamazine and his swelling disappeared. He was followed for 4 months and is doing well.</p><p>Filariasis is a major health problem in tropical countries including the Indian subcontinent. It is caused by any of three closely related parasitic nematodes - <italic>Wuchereria bancrofti, Brugia malayi</italic> or <italic>Brugia timori</italic>.</p><p><italic>Wuchereria bancrofti</italic>, a human nematode parasite, is capable of producing disease due to migration of adult parasite through the lymphatic system.[<xref ref-type="bibr" rid="CIT1">1</xref>] The adult <italic>Wuchereria bancrofti</italic> may produce lesions by involving the lymphatics of the lower limbs, spermatic cord, epididymis, testis, retroperitoneum and female breast.[<xref ref-type="bibr" rid="CIT1">1</xref>] Its typical presentation are elephantiasis, chronic lymphoedema, epididymitis, funiculitis and lymphadenitis.[<xref ref-type="bibr" rid="CIT1">1</xref><xref ref-type="bibr" rid="CIT2">2</xref>] In spite of a large number of such lesions diagnosed on cytology, it is unusual to find adult filarial worms.</p><p>Most people with microfilaraemia do not show signs or symptoms of the disease but are important source of infection in the community. Symptomatic lymphatic filariasis has very low microfilaraemia. Thus, disease and infection do not necessarily accompany each other.[<xref ref-type="bibr" rid="CIT3">3</xref>]</p><p>In the present case, the patient had a solitary swelling from which fluid and fragment of adult worm was aspirated. There are a few reports of adult filarial worms in aspirates of soft tissue swellings,[<xref ref-type="bibr" rid="CIT1">1</xref><xref ref-type="bibr" rid="CIT3">3</xref>] lymph node[<xref ref-type="bibr" rid="CIT4">4</xref><xref ref-type="bibr" rid="CIT5">5</xref>] and epididymal nodules. In all these cases, the swelling was painless and the patient was asymptomatic. In none of the cases, a clinical diagnosis of filariasis was considered. Most of the soft tissue swellings associated with fever are diagnosed as tuberculous or pyogenic. FNAC can distinguish between these swellings accurately and plays an important role in their correct diagnosis.</p><p>Thus, in countries where lymphatic filariasis is endemic, it should be considered in the clinical differential diagnosis of a soft tissue swelling. FNAC is a convenient and effective diagnostic method in patients with soft tissue mass. Thus, to conclude, identification of parasite in cytology smears plays an important role in diagnosis of disease and institution of specific treatment.</p></body><back><ref-list><ref id="CIT1"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kapila</surname><given-names>K</given-names></name><name><surname>Verma</surname><given-names>K</given-names></name></person-group><article-title>Gravid adult female worms of <italic>Wuchereria bancrofti</italic> in fine needle aspirates of soft tissue swellings - report of three cases</article-title><source>Acta Cytol</source><year>1989</year><volume>33</volume><fpage>390</fpage><lpage>2</lpage><pub-id pub-id-type="pmid">2658448</pub-id></element-citation></ref><ref id="CIT2"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Garbyal</surname><given-names>RS</given-names></name><name><surname>Arundhati</surname></name><name><surname>Bohra</surname><given-names>A</given-names></name><name><surname>Bhujan</surname><given-names>KH</given-names></name></person-group><article-title>An unusual presentation of filariasis</article-title><source>Acta Cytol</source><year>2008</year><volume>52</volume><fpage>204</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">18499995</pub-id></element-citation></ref><ref id="CIT3"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pandit</surname><given-names>AA</given-names></name><name><surname>Shah</surname><given-names>RK</given-names></name><name><surname>Shenoy</surname><given-names>SG</given-names></name></person-group><article-title>Adult filarial worm in a fine needle aspirate of a soft tissue swelling</article-title><source>Acta Cytol</source><year>1997</year><volume>41</volume><fpage>944</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">9167733</pub-id></element-citation></ref><ref id="CIT4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mitra</surname><given-names>SK</given-names></name><name><surname>Mishra</surname><given-names>RK</given-names></name><name><surname>Verma</surname><given-names>P</given-names></name></person-group><article-title>Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh</article-title><source>J Cytol</source><year>2009</year><volume>26</volume><fpage>11</fpage><lpage>4</lpage></element-citation></ref><ref id="CIT5"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arora</surname><given-names>VK</given-names></name><name><surname>Sen</surname><given-names>B</given-names></name><name><surname>Dev</surname><given-names>G</given-names></name><name><surname>Bhatia</surname><given-names>A</given-names></name></person-group><article-title>Fine needle aspiration of the adult worm of <italic>Brugia malayi</italic> and its ovarian fragment from an epitrochlear lymph node</article-title><source>Acta Cytol</source><year>1993</year><volume>37</volume><fpage>437</fpage><lpage>8</lpage><pub-id pub-id-type="pmid">8498146</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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