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Case report
Rare association of microfilaria with poorly differentiated mucin-secreting metastatic carcinoma in liver aspirate cytology
  1. Renuka Gahine1,
  2. Aditi Das1,
  3. Vishal Kumar Jain2 and
  4. Apurva Agrawal1
  1. 1 Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
  2. 2 Radiodiagnosis, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
  1. Correspondence to Dr Aditi Das; mdmedico09{at}gmail.com

Abstract

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.

  • tropical medicine (infectious disease)
  • global health
  • oncology
  • pathology
  • public health

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Footnotes

  • Contributors RG and AD are joint first authors, they contributed equally and were responsible for the conception, drafting and critical revision of the manuscript for important intellectual content. AD analysed the patient information, performed the literature search and wrote the manuscript. RG provided the expertise, mentorship and guidance with regard to the drafting of manuscript. VKJ provided the radiological opinion and detailed CT scan images. AA was involved in patient’s care, obtained the patient details and revised the manuscript for important intellectual content. All the authors have read and approved the final version of the manuscript and have agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.