Journal of Postgraduate Medicine Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India ISSN: 0022-3859 EISSN: 0972-2823 Vol. 47, Num. 2, 2001, pp. 143

Journal of Postgraduate Medicine, Vol. 47, Issue 2, 2001 pp.

Letter to Editor

Soft Tissue Swelling: Cytology Comes to Rescue

Chaturvedi S(1), Arora VK(2)

(1)Institute of Human Behaviour and Allied Sciences, (2)University College of Medical Sciences, Delhi, India.

Code Number: jp01043

Sir,

We wish to report a case of a 14 years old boy from Delhi who presented with a tender swelling just above the cubital fossa of left arm. It was approximately 3x2 cms in size and of a month’s duration. There were no other complaints or findings. Prior treatment consisted of topical application of some herbal medicines. Results of routine blood studies were normal. Fine needle aspiration was attempted. A pownish aspirate was obtained. Smears were moderately cellular. In a background of dirty necrotic material were seen abundant eosinophils, polymorphs and histiocytes. Segment of an adult female filarial worm with smooth cuticle was identifiable. Its internal reproductive system showed characteristic long ovaries with numerous nuclei and lipid droplets (Figure). No eggs or microfilariae were seen.

The adult worms of the common filarial species found in India, viz. W. bancrofti and B. malayi, have a smooth cuticle but none is known to inhabit subcutaneous tissue and skin. This case is unusual, both, in its presentation and cytomorphology. Primary presentation as a subcutaneous nodule is unusual in species found in India. Moreover, aspirates from a lesion of filarial pathology usually contain microfilariae. Isolated finding of a non-gravid adult female worm is uncommon. In an earlier study of 34 cases of lymphatic filariasis, non-gravid female was seen only in one.(1) Our patient responded well to antifilarial treatment. The authors wish to reinforce the role of aspiration cytology in the diagnosis of lymphatic filariasis.(2)

References

1. Arora VK, Singh N, Bhatia A. Cytomorphologic profile of lymphatic filariasis. Acta Cytol 1996; 40:948-952. MEDLINE
2. Kapila K, Verma K. Gravid adult female worms of W. bancrofti in fine needle aspirate of soft tissue swelling - report of three cases. Acta Cytol 1989; 33:390-392. MEDLINE

This article is also available in full-text from http://www.jpgmonline.com/

© Copyright 2001 - Journal of Postgraduate Medicine

The following images related to this document are available:

Photo images