Role of Cytology in Detection of Unsuspected Carriers of Microfilariae: A Retrospective Study in National Capital Region (NCR), India
Keywords:
Microfilaria, filariasis, Fine needle aspiration cytology (FNAC), exfoliative cytology
Abstract
Background: Filariasis, a global problem, is a major public health issue in India. Despite its high incidence, it is unusual to detect microfilaria in cytological smears, though unexpected detection of microfilariae in fine needle aspiration cytology (FNAC), exfoliative and fluid cytology have been reported previously. The study analyzed the role of cytology in detection of asymptomatic carriers of microfilariae.Methods: This was a retrospective, observational study and included cases of filariasis from cytological records spanning five years. The epidemiological, clinical, hematologic and radiologic details were noted. The slides were retrieved and examined. Descriptive statistical analysis was utilized.Result: Filariasis was diagnosed in 0.03% of the total cytology cases studied during the period, constituting 0.04% of FNACs (two cases of inguino-scrotal swellings, two of breast lumps, one of thyroid swelling) and 0.02% of cervicovaginal smears (two cases). None of them was clinically suspected to be filariasis. Radiological examination was also misleading. None of the cases demonstrated raised leukocytosis or microfilaremia and eosinophilia was present in 3 cases (42.9%). Apart from microfilariae of Wuchereria bancrofti, eggs were present in one case. This was associated with inflammation in all cases, cell adherence in 42.9% and coexistent hyperplastic and neoplastic conditions in 57.1% cases.Conclusion: The detection of microfilariae in cytological material in the absence of clinical, radiologic or hematologic suspicion, in an area of relatively low prevalence of filaria, points to the need for a high index of suspicion and careful screening of all smears, as cytology may play an important role in the diagnosis of asymptomatic carriers of microfilariae.DOI:10.21276/APALM.1727References
1. World Health Organization. Programmes. Lymphatic filariasis. Epidemiology. Available from http://www.who.int/lymphatic_filariasis. Last accessed on 24 October 2017.
2. Park K. Lymphatic Filariasis: Park’s textbook of preventive and social medicine, 22nd Edition 2013. Jabalpur. Banarasidas Bhanot: 245-50.
3. National Vector Borne Disease Control Programme. Directorate General of Health Services. Ministry of Health & Family Welfare. Diseases. Filariasis. Magnitude of the disease. Available from http://www.nvbdcp.gov.in/filariasis. Last accessed on 24 October 2017.
4. Santosh T. Microfilariae in Fine Needle Aspirates From a Coastal District of India: An Experience With Brief Review of Literature. J Trop Dis 2017;5(2):10233.
5. Krishna M, Dayal S. Microfilaria in cytological smears at rare sites coexisting with unusual pathologies - A series of eight cases. Ann. Clin. Chem. Lab. Med . 2016:2(1);28-31.
6. Khare P, Kala P, Jha A, Chauhan N, Chand P. Incidental Diagnosis of Filariasis in Superficial Location by FNAC: A Retrospective Study of 10 Years. J Clin Diagn Res. 2014 Dec;8(12):5–8.
7. Pantola C, Kala S, Agarwal A, Khan L. Microfilaria in cytological smears at rare sites coexisting with unusual pathology: A series of seven cases. Trop Parasitol. 2012 Jan-Jun; 2(1): 61–63.
8. Mondal SK. Incidental detection of filaria in fine-needle aspirates: a cytologic study of 14 clinically unsuspected cases at different sites. Diagn Cytopathol. 2012 Apr;40(4):292-6.
9. Kumar B, Karki S, Yadava SK. Role of fine needle aspiration cytology in diagnosis of filarial infestation. Diagn Cytopathol. 2011 Jan;39(1):8-12.
10. Gupta S, Gupta R, Bansal B, Singh S, Gupta K, Kudesia M. Significance of incidental detection of filariasis on aspiration smears: a case series. Diagn Cytopathol. 2010 Jul;38(7):517-20.
11. Mitra SK, Mishra RK, Verma P. Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh. J Cytol. 2009 Jan;26(1):11-4.
12. Jha A, Shrestha R, Aryal G, Pant AD, Adhikari RC, Sayami G. Cytological diagnosis of bancroftian filariasis in lesions clinically anticipated as neoplastic . Nepal Med Coll J 2008; 10(2): 108-114.
13. Yenkeshwar PN, Kumbhalkar DT, Bobhate SK. Microfilariae in fine needle aspirates: a report of 22 cases. Indian J Pathol Microbiol. 2006 Jul;49(3):365-9.
14. Gupta K, Sehgal A, Puri MM, Sidhwa HK. Microfilariae in association with other diseases. A report of six cases. Acta Cytol. 2002 Jul-Aug;46(4):776-8.
15. Varghese R, Raghuveer CV, Pai MR, Bansal R. Microfilariae in cytologic smears: a report of six cases. Acta Cytol. 1996;40:299-301.
16. Walter A, Krishnaswami H, Cariappa A. Microfilariae of Wuchereria bancrofti in cytologic smears. Acta Cytol. 1983;27:432-6.
17. Pandit CG, Pandit SR, Iyer SPV. The adhesion phenomenon in filariasis: a preliminary note. Indian J Med Res. 1929;16(4):946-53.
18. Bain O, Babayan S. Behaviour of filariae: morphological and anatomical signatures of their life style within the arthropod and vertebrate hosts. Filaria J. 2003 Dec 15;2(1):16.
19. Bagla N, Patel MM, Pandya AN, Thakral C. Microfilariae in cytology smears: real culprits or trapped accidentally by needles? A study of 10 cases. Cytopathology. 2005 Dec;16(6):316-7.
20. Sane KC, Bholay SU, Bari VB, Kulkarni MN.Microfilaria Coexistent with Fibroadenoma – An Unusual Association.J Clin Diagn Res 2015 Oct; 9(10):15-6.
21. Ahluwalia C1, Choudhury M, Bajaj P. Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone. Diagn Cytopathol. 2003 Jul;29(1):31-2.
22. Gupta S, Sodhani P, Jain S, Kumar N. Microfilariae in association with neoplastic lesions: Report of five cases. Cytopathology. 2001 Apr 1;12(2):120-6.
23. Malik A, Singh N, Arora VK, Bhatia A. Association of microfilariae with leprosy and other diseases. Acta Cytol. 2002 Jan-Feb;46(1):69-70.
24. Singh MK, Rao IS, Kapila K. Microfilariae in fine needle aspiration smears from lesions of nodular leprosy. Acta Cytol. 2000 Mar-Apr;44(2):278-9.
25. Jain S, Sodhani P, Gupta S, Sakhuja P, Kumar N. Cytomorphology of Filariasis Revisited. Expansion of the Morphologic Spectrum and Coexistence with Other Lesions. Acta Cytol. 2001;45:186-91.
26. Pradhan S, Lahiri VL, Elhence BR, Singh KN. Microfilaria of Wuchereria Bancrofti in Bone Marrow Smear. Am J Trop Med Hyg 1976;25:199 - 200.
2. Park K. Lymphatic Filariasis: Park’s textbook of preventive and social medicine, 22nd Edition 2013. Jabalpur. Banarasidas Bhanot: 245-50.
3. National Vector Borne Disease Control Programme. Directorate General of Health Services. Ministry of Health & Family Welfare. Diseases. Filariasis. Magnitude of the disease. Available from http://www.nvbdcp.gov.in/filariasis. Last accessed on 24 October 2017.
4. Santosh T. Microfilariae in Fine Needle Aspirates From a Coastal District of India: An Experience With Brief Review of Literature. J Trop Dis 2017;5(2):10233.
5. Krishna M, Dayal S. Microfilaria in cytological smears at rare sites coexisting with unusual pathologies - A series of eight cases. Ann. Clin. Chem. Lab. Med . 2016:2(1);28-31.
6. Khare P, Kala P, Jha A, Chauhan N, Chand P. Incidental Diagnosis of Filariasis in Superficial Location by FNAC: A Retrospective Study of 10 Years. J Clin Diagn Res. 2014 Dec;8(12):5–8.
7. Pantola C, Kala S, Agarwal A, Khan L. Microfilaria in cytological smears at rare sites coexisting with unusual pathology: A series of seven cases. Trop Parasitol. 2012 Jan-Jun; 2(1): 61–63.
8. Mondal SK. Incidental detection of filaria in fine-needle aspirates: a cytologic study of 14 clinically unsuspected cases at different sites. Diagn Cytopathol. 2012 Apr;40(4):292-6.
9. Kumar B, Karki S, Yadava SK. Role of fine needle aspiration cytology in diagnosis of filarial infestation. Diagn Cytopathol. 2011 Jan;39(1):8-12.
10. Gupta S, Gupta R, Bansal B, Singh S, Gupta K, Kudesia M. Significance of incidental detection of filariasis on aspiration smears: a case series. Diagn Cytopathol. 2010 Jul;38(7):517-20.
11. Mitra SK, Mishra RK, Verma P. Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh. J Cytol. 2009 Jan;26(1):11-4.
12. Jha A, Shrestha R, Aryal G, Pant AD, Adhikari RC, Sayami G. Cytological diagnosis of bancroftian filariasis in lesions clinically anticipated as neoplastic . Nepal Med Coll J 2008; 10(2): 108-114.
13. Yenkeshwar PN, Kumbhalkar DT, Bobhate SK. Microfilariae in fine needle aspirates: a report of 22 cases. Indian J Pathol Microbiol. 2006 Jul;49(3):365-9.
14. Gupta K, Sehgal A, Puri MM, Sidhwa HK. Microfilariae in association with other diseases. A report of six cases. Acta Cytol. 2002 Jul-Aug;46(4):776-8.
15. Varghese R, Raghuveer CV, Pai MR, Bansal R. Microfilariae in cytologic smears: a report of six cases. Acta Cytol. 1996;40:299-301.
16. Walter A, Krishnaswami H, Cariappa A. Microfilariae of Wuchereria bancrofti in cytologic smears. Acta Cytol. 1983;27:432-6.
17. Pandit CG, Pandit SR, Iyer SPV. The adhesion phenomenon in filariasis: a preliminary note. Indian J Med Res. 1929;16(4):946-53.
18. Bain O, Babayan S. Behaviour of filariae: morphological and anatomical signatures of their life style within the arthropod and vertebrate hosts. Filaria J. 2003 Dec 15;2(1):16.
19. Bagla N, Patel MM, Pandya AN, Thakral C. Microfilariae in cytology smears: real culprits or trapped accidentally by needles? A study of 10 cases. Cytopathology. 2005 Dec;16(6):316-7.
20. Sane KC, Bholay SU, Bari VB, Kulkarni MN.Microfilaria Coexistent with Fibroadenoma – An Unusual Association.J Clin Diagn Res 2015 Oct; 9(10):15-6.
21. Ahluwalia C1, Choudhury M, Bajaj P. Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone. Diagn Cytopathol. 2003 Jul;29(1):31-2.
22. Gupta S, Sodhani P, Jain S, Kumar N. Microfilariae in association with neoplastic lesions: Report of five cases. Cytopathology. 2001 Apr 1;12(2):120-6.
23. Malik A, Singh N, Arora VK, Bhatia A. Association of microfilariae with leprosy and other diseases. Acta Cytol. 2002 Jan-Feb;46(1):69-70.
24. Singh MK, Rao IS, Kapila K. Microfilariae in fine needle aspiration smears from lesions of nodular leprosy. Acta Cytol. 2000 Mar-Apr;44(2):278-9.
25. Jain S, Sodhani P, Gupta S, Sakhuja P, Kumar N. Cytomorphology of Filariasis Revisited. Expansion of the Morphologic Spectrum and Coexistence with Other Lesions. Acta Cytol. 2001;45:186-91.
26. Pradhan S, Lahiri VL, Elhence BR, Singh KN. Microfilaria of Wuchereria Bancrofti in Bone Marrow Smear. Am J Trop Med Hyg 1976;25:199 - 200.
Published
2018-04-28
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
