Skin ulcerations are a significant cause of morbidity and can be challenging to manage. Among the various causes of chronic non-healing ulcers, lymphedema is also considered a possible diagnosis in countries such as Nepal. Lymphatic filariasis has been a significant public health issue in endemic areas. Wuchereria bancrofti is a common nematode parasite that causes lymphatic filariasis. Excessive retention of lymphatic fluid in the interstitial compartment can cause localized tissue swelling, known as lymphedema, which is caused by impaired lymphatic drainage. Microfilariae can be detected in peripheral blood, body fluids, and needle aspirates. Microfilaria is not commonly found in ulcers on elephantiasis legs. We discuss here a case of 73-year-old women with elephantiasis legs with pus discharging ulcers in the thighs. Microscopic examination of pus discharge revealed microfilaria which highlights the importance of pus examination as diagnostic modality in endemic countries.

Filariasis is a global public health problem. We routinely examine it in peripheral smears made from samples collected during the night. Though the prevalence is high, microfilariae are rarely found in cytology smears. A lymph node presenting as a filarial nodule is an unusual occurrence. Also, lymph node fine needle aspiration cytology (FNAC) with a finding of microfilariae is uncommon. We would like to report the case of incidental microfilariae finding in a patient who presented with a supraclavicular lymph node mass. The patient presented with a right supraclavicular lymph node mass of size 2 cm × 2 cm and severe fever during the night for six months. The USG-neck region revealed enlarged lymph nodes in the right supraclavicular region. She was provisionally diagnosed as a case of cervical lymph node swelling under evaluation. However, on ultrasound-guided FNAC of the lymph node, microfilariae were found incidentally. In cases where clinical presentations of filariasis are absent, FNAC may aid in the diagnosis of microfilariae in the lymph node.

Filariasis is a common parasitic infection in India. It is rare to find neglected cases of Filariasis nowadays. We reported the presence of microfilaria species in the follicular fluid of an egg donor undergoing an ovum pick up procedure. She was a 23-year-old egg donor who underwent stimulation using the GnRH antagonist protocol. Antagonist protocol is one of the standard protocols used for controlled ovarian hyperstimulation as a part of the IVF/ICSI(in-vitro fertilization / intracytoplasmic sperm injection) procedure where GnRH antagonist (cetrorelix) is used to suppress the endogenous LH surge. Her baseline investigations were normal, with no significant history suggestive of any worm infestations. During the ovum pickup procedure, follicular fluid revealed the presence of worm-like structures suggestive of larvae of some parasites. The follicular fluid was sent to the microbiology department along with the blood sample to confirm the parasite species. The parasite was found to be the larvae of W. Bancroft. The oocytes were of poor quality and were discarded. The patient was treated with Diethylcarbamazine citrate. There are so many reports about scrotal Filariasis, but rare literature quotes ovarian Filariasis.

Dirofilaria repens and Dirofilaria immitis are the most common filarial species affecting humans in Europe. Dirofilaria repens causes subcutaneous or ocular infection, whereas D. immitis is responsible mainly for the pulmonary form. In this report, we present the first human case of periorbital dirofilariasis in the Czech Republic. A 58-year-old woman suffered from an eyelid oedema, redness and pain in the left eye. After excising the parasite from her eyelid, all clinical symptoms disappeared. Based on the morphology and cytochrome oxidase I sequencing, the parasite was identified as D. repens. Histology revealed that the excised worm was female with absent microfilariae in uteri. With respect to the length of the incubation period and the sequence identity with a known Czech isolate, we concluded that D. repens was most likely of autochthonous origin.

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Isolated pleural effusion is a rare manifestation of filariasis that mimics tuberculosis, especially in endemic regions. We describe a case of lymphocytic and exudative pleural effusion showing microfilaria on pleural fluid cytology. A retrospective review of all cases of filarial pleural effusion reported after 2000 was conducted to evaluate the association between filariasis and pleural effusion as well as to screen the features that can help in accurate detection of these patients. The analysis suggested a causal association between the parasite and the development of pleural effusion with a high sensitivity of pleural fluid cytology for diagnosis.

Filariasis is a vector-borne disease, which is quite common in tropical countries such as India. In India, it is most commonly caused either by Wuchereria bancrofti or Brugia malayi. It can present in any possible site, possibly, because of their ability to migrate along the lymphatics. Very few cases have been reported in the literature where microfilariae have been found in cervicovaginal smears. Most of the cases have been reported on conventional Pap smears. Here, we present two such cases where microfilaria was found as an incidental finding in liquid-based cytology preparation.

BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: 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.
CONCLUSIONS: 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.

Filariasis is a major public health problem in tropical and subtropical countries such as India. It is caused by nematodes, principally Wuchereria bancrofti and Brugia malayi and is transmitted by the Culex mosquito. W.bancrofti accounts for 90% of cases of lymphatic filariasis. Filaria of the breast with axillary lymphadenopathy and lymphedema, mimicking breast carcinoma has been previously reported. Microfilariae have also been previously observed as coincidental findings with various inflammatory and neoplastic lesions. Few examples are hemangiomas of the liver, meningiomas, intracranial hemangioblastomas, uterine cervix, pharyngeal, urinary bladder, preputial and metastatic carcinomas, melanomas, and leukemia.Here, we report an unusual case of filarial infection of a metastatic axillary node in a case of invasive breast carcinoma, observed in a modified radical mastectomy specimen. Previous cases reported in literature have reported microfilaria in metastatic axillary node detected on cytology specimens; histological diagnosis, though reported, is rare.