Incidental detection of an isolated microfilaria in squash cytology of an oligodendroglioma: the unexpected ‘worm’ in the pie

Space occupying lesion of brain: An unusual site for a common infection

Filariasis is a public health menace and is a cause for concern due to its endemicity in tropical and subtropical countries of Africa, Asia, and Western Pacific. Even in endemic areas, it is rare to find filariasis in fluid specimens especially cerebrospinal fluid. Herein, we report a case of unsuspected filarial parasitic infection in an adult male admitted as a case of space occupying lesion in brain with suspicion of lymphoma/granulomatous disease on the basis of clinicoradiological details. To the best of our knowledge, such an extensive brain involvement by filariasis has not been reported before.

Rare association of microfilaria with poorly differentiated mucin-secreting metastatic carcinoma in liver aspirate cytology

Filariasis, a neglected tropical disease (NTD), is mainly caused by nematodes-Wuchereria bancrofti, Brugia malayi and B. timori Apart from profoundly disabling and disfiguring major clinical manifestations-lymphoedema, elephantiasis and hydrocoele-asymptomatic microfilaremia is common in endemic areas. Despite this, it is very rare to detect microfilariae in body fluids or aspirates. As per the literature search, this is the third case documenting incidental detection of microfilariae with metastatic deposits in the liver aspirate. Here, a 35-year-old man underwent image-guided fine-needle aspiration cytology of liver nodule. Liver aspirate cytology revealed poorly differentiated mucin-secreting metastatic carcinoma and coincidental presence of microfilariae of W. bancrofti Recently, microfilaria has frequently been found to be associated with the debilitated, immunocompromised condition and various neoplasm/cancer/malignancy. Hence, meticulous investigation should be undertaken to search for hidden pathology, whenever microfilariae are detected; and to deeply scrutinise aspirates for such parasites always, especially in endemic regions.

Central nervous system filariasis masquerading as a glioma: case report

Filariasis, an endemic zoonosis in the Southeast Asia region, has been reported to affect various organs as well as the central nervous system (CNS). Inflammatory reactions mimicking those from neoplastic lesions clinically and radiologically have been reported in the breast and urinary bladder. To date, a CNS manifestation of filarial infestation has been reported in the form of meningoencephalitis. The authors here present an interesting case of a young man presenting in status epilepticus, which on radiological evaluation appeared to be a glioma. However, postoperative histopathological examination changed the provisional diagnosis to a filarial infection of the CNS mimicking a primary CNS neoplasm.