1
|
Alonso FH, Shapiro K, Camp LE. Can nematode infection cause internal bleeding in dogs? A case of Dirofilaria immitis infection in cavitary fluids. Vet Clin Pathol 2024; 53:250-254. [PMID: 38684482 DOI: 10.1111/vcp.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
A 9-year-old dog was presented with weight loss, respiratory effort, and an enlarged abdomen. Imaging studies and exploratory surgery showed pulmonary and splenic masses and bi-cavitary effusion, later classified as hemorrhage. Cytology of the peritoneal and pleural fluids also revealed several microfilariae. Immunologic and molecular analyses confirmed Dirofilaria immitis infection and histopathology of the spleen indicated a cavernous endothelial proliferation with undefined etiology (hemangiosarcoma vs reaction to parasite infestation). The nematode larvae are speculated to have entered body cavities via erratic migration or via hemorrhage and visceral lesions to be related to parasitism. Nematode infection should be considered as a differential diagnosis for internal bleeding of undetermined origin.
Collapse
Affiliation(s)
- Flavio H Alonso
- Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
- Department of Comparative Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Karen Shapiro
- Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Lauren E Camp
- Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| |
Collapse
|
2
|
Vasantham V, Yadav SK, Sarin N, Singh S, Pruthi SK. Incidental detection of microfilaria in cyst fluid of Mucinous cystadenocarcinoma of ovary: A rare case report. Int J Surg Case Rep 2020; 70:56-59. [PMID: 32416487 PMCID: PMC7229237 DOI: 10.1016/j.ijscr.2020.04.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Filariasis is a major health problem in certain parts of India. Microfilaria detection on exfoliative and fluid cytology is extremely rare and it is even very rare to find microfilaria coexistent with neoplastic lesions. PRESENTATION OF CASE A 45-year-old nulliparous female, who presented with complaints of lower abdominal swelling and pain. Initially, a clinical diagnosis of cystadenoma was made. Ascitic fluid cytology of the patient showed 3-dimensional clusters of cells along with an occasional microfilaria. On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made. DISCUSSION Most common cause of lymphatic filariasis is W. bancrofti followed by Brugia species and it affects young adults. The adult form of the filaria lodge in lymph vessels, and due to lymphatic blockage in neoplasms they appear in tissue fluid or on surface material. It is the first case report of microfilaria being detected in ovarian cystic fluid cytology in a patient of Mucinous cystadenocarcinoma of ovary. CONCLUSION Filaria is an incidental finding in most of the cases, hence, cytopathologist should be vigilant and careful screening of all the slides should be done, especially in a country like India, where it is highly endemic.
Collapse
Affiliation(s)
- Vyshnavi Vasantham
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shakti Kumar Yadav
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Namrata Sarin
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sompal Singh
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sonam Kumar Pruthi
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India.
| |
Collapse
|
3
|
Martínez-Girón R, Pantanowitz L. An odd curiosity: Meristematic tissue in a breast fine-needle aspirate. Diagn Cytopathol 2019; 48:90-91. [PMID: 31682082 DOI: 10.1002/dc.24332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/16/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Rafael Martínez-Girón
- Departament of Health, Anatomic Pathology and Cytodiagnosis, CFP San Juan de la Cruz, Madrid, Spain
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center Shadyside, Pittsburgh, Pennsylvania
| |
Collapse
|
4
|
Glaser LJ, Montone KT. A Practical Guide to the Role of Ancillary Techniques in the Diagnosis of Infectious Agents in Fine Needle Aspiration Samples. Acta Cytol 2019; 64:81-91. [PMID: 30889574 DOI: 10.1159/000497076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/19/2019] [Indexed: 12/17/2022]
Abstract
Fine needle aspiration samples and small biopsies provide a minimally invasive diagnostic modality for mass lesions. When an infectious process is suspected based on initial evaluation, ancillary techniques can assist in making a specific diagnosis. Here we review the cytopathology that should prompt additional testing and review the availability and interpretation of special stains, immunohistochemistry, and in situ hybridization. In addition, this review addresses when special cultures may be necessary and the use of newer molecular techniques for pathogen identification.
Collapse
Affiliation(s)
- Laurel J Glaser
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathleen T Montone
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,
| |
Collapse
|
5
|
Mohan N, Agrawal R, Kumar P. Breast ductal carcinoma with coexistent microfilaria: Diagnosed on cytology. Trop Parasitol 2018; 8:103-105. [PMID: 30693217 PMCID: PMC6329269 DOI: 10.4103/tp.tp_34_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2018] [Indexed: 11/16/2022] Open
Abstract
Filariasis is a major health problem of the tropical and subtropical regions, but filariae are also found in temperate climates. The disease is endemic all over India and microfilariae have been observed as coincidental findings with inflammatory conditions and neoplastic lesions. We report a rare case of a 40-year-old female from a nonendemic area presenting with lump in the left breast. The skin overlying the mass was fungating and ulcerated. Ipsilateral axillary lymph nodes were palpable. Fine-needle aspiration cytology revealed highly cellular smears having ductal epithelial cells arranged in groups, tight clusters, and scattered singly. Cells were large, having pleomorphic round to oval nuclei with prominent nucleoli. Along with these tumor cells, sheathed microfilariae of Wuchureria bancrofti were seen, suggesting a diagnosis of ductal carcinoma with coexistent microfilaria of W. bancrofti. Findings were confirmed on histopathology of the resected specimen following modified radical mastectomy. Coexistent pathologies should always be considered while reporting.
Collapse
Affiliation(s)
- Nitesh Mohan
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Ranjan Agrawal
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| | - Parbodh Kumar
- Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| |
Collapse
|
6
|
Abstract
In determining the etiology of eosinophilia, it is necessary to consider the type of patient, including previous travel and exposure history, comorbidities, and symptoms. In this review, we discuss the approach to the patient with eosinophilia from an infectious diseases perspective based on symptom complexes.
Collapse
Affiliation(s)
- Elise M O'Connell
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA.
| | - Thomas B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA
| |
Collapse
|
7
|
Pandey A, Masood S, Awasthi NP. Cystic microfilarial infestation of the liver: a rare presentation. Int J Infect Dis 2014; 31:15-7. [PMID: 25499038 DOI: 10.1016/j.ijid.2014.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 12/02/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022] Open
Abstract
Cystic liver lesions in an adult may occur for a variety of reasons, most of which are benign in nature. Infiltrating benign lesions in the liver parenchyma may pose a clinical challenge in diagnosis and management. In the case presented herein, a cystic lesion adjacent to the gall bladder and involving the liver parenchyma had to be differentiated from gall bladder carcinoma, which is quite common in India. Parasitic infestation of the liver is an extremely rare presentation and may pose a significant challenge in its diagnosis and management. This case highlights an infrequent presentation and the challenges in the clinical approach and subsequent management.
Collapse
Affiliation(s)
- Anshuman Pandey
- Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India.
| | - Shakeel Masood
- Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
| | - Namrata P Awasthi
- Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Gomti Nagar, Lucknow, Uttar Pradesh, India
| |
Collapse
|
8
|
Singh AK, Gupta P, Yadav S, Pahawa HS. Incidental detection microfilaria in subcutaneous breast nodule of lactating female fnac: a rare case report. J Clin Diagn Res 2014; 8:FD03-4. [PMID: 25120989 DOI: 10.7860/jcdr/2014/7494.4418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 02/17/2014] [Indexed: 11/24/2022]
Abstract
Filariasis is a major public health problem which is faced in tropical countries like India. Its diagnosis is made by using peripheral blood smears. However, microfilaria has been detected incidentally during FNACs of various lesions, which were done in clinically unsuspected cases. We are reporting here, an uncommon case of filariasis, which caused a nodular, subcutaneous swelling in left breast of a 30 year old lactating female. A nodular subcutaneous swelling can be caused in breast of a lactating female by lactational associated mastitis, but filaria causing a nodular swelling in a lactating breast is a rare presentation. Aspiration of the swelling demonstrated enormous pathogen presence caused by Woucheria bancrofti and the patient responded well to six weeks of daily anti-filarial treatment with diethylcarbamazine citrate.
Collapse
Affiliation(s)
- Ajay Kr Singh
- Assistant Professor, Department of Pathology, King George's Medical University , Lucknow, UP, India
| | - Prashant Gupta
- Assistant Professor, Department of Microbiology, King George's Medical University , Lucknow, UP, India
| | - Soma Yadav
- Resident Doctor, Department of Pathology, King George's Medical University , Lucknow, UP, India
| | - H S Pahawa
- Professor, Department of Surgery, King George's Medical University , Lucknow, UP, India
| |
Collapse
|
9
|
Handa U, Kundu R, Singhal N, Mohan H. Diagnosis of filariasis on cytology: a series of 24 cases. Trop Doct 2013; 44:92-5. [DOI: 10.1177/0049475513516951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Filariasis has a worldwide distribution, with a special predilection for tropical and subtropical areas. The microfilaria wanders in lymphatics and can be accidentally trapped in the needle during fine-needle aspiration cytology, thus leading to its incidental detection. This is a retrospective study of 24 cases of microfilarial infestation diagnosed on cytology. Accurate recognition and detection of the parasite leads to the institution of specific treatment and prevents chronic manifestations of the disease.
Collapse
Affiliation(s)
- Uma Handa
- Professor, Department of Pathology, Government Medical College and Hospital, India
| | - Reetu Kundu
- Senior Resident, Department of Pathology, Government Medical College and Hospital, India
| | - Niti Singhal
- Assistant Professor, Department of Pathology, Government Medical College and Hospital, India
| | - Harsh Mohan
- Professor & Head, Department of Pathology, Government Medical College and Hospital, India
| |
Collapse
|
10
|
Roethlisberger M, Wuerstlein R, Majores M, Müller-Stöver I, Seitz HM, Rhiem K, Kraemer S, Mallmann P, Büttner R, Harbeck N. Filariasis of the axilla in a patient returning from travel abroad: a case report. ACTA ACUST UNITED AC 2012; 7:487-9. [PMID: 24715832 DOI: 10.1159/000345471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites. PATIENTS AND METHODS A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy. RESULTS On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae. CONCLUSION Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.
Collapse
Affiliation(s)
- Maria Roethlisberger
- Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany
| | - Rachel Wuerstlein
- University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany
| | - Michael Majores
- CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Bonn, Germany
| | - Irene Müller-Stöver
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Dusseldorf, Germany
| | - Hanns M Seitz
- Department of Microbiology, University Hospital of Bonn, Germany
| | - Kerstin Rhiem
- Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany
| | - Stefan Kraemer
- Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany
| | - Peter Mallmann
- Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany
| | - Reinhard Büttner
- CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Cologne, Germany
| | - Nadia Harbeck
- University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany
| |
Collapse
|
11
|
Ahuja A, Das P, Durgapal P, Saini A, Dogra PN, Mathur SR, Iyer VK. Microfilaria in a patient of achylous hematuria: A rare finding in urine cytology. J Cytol 2012; 29:147-8. [PMID: 22787301 PMCID: PMC3391801 DOI: 10.4103/0970-9371.97163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Filariasis is a widespread public health problem seen commonly in tropical countries. Microfilariae have been reported in aspiration smears from various sites. However, it is very rare to detect these organisms in voided centrifuged urine cytology. We, report this rare finding in a 25-year-old patient who presented with achylous hematuria.
Collapse
Affiliation(s)
- Arvind Ahuja
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | |
Collapse
|
12
|
Aplastic anaemia with microfilaria in marrow aspirate. Mediterr J Hematol Infect Dis 2012; 4:e2012019. [PMID: 22550564 PMCID: PMC3340988 DOI: 10.4084/mjhid.2012.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 02/02/2012] [Indexed: 11/08/2022] Open
Abstract
Wuchereria bancrofti is endemic in many parts of of south east asia including india. The parasite is reported previously in many aspirate cytology smears, however its rare to find this parasite in bone marrow aspirate smear and even rare is it association with aplastic anemia. We report here a case presenting with symptoms related to bone marrow failure and incidentally detected to have microfilaria of Wuchereria bancrofti. The case is reported because of this rare association.
Collapse
|