Fine needle aspiration of retroperitoneal human dirofilariasis with a pseudotumoral presentation

The accidental finding of a pseudotumoral para-aortic mass in a 60-year-old woman led to the performance of a fine needle aspiration (FNA) biopsy under ultrasonographic guidance. The milky aspirate was centrifuged and processed as a cell block. The examination of sections confirmed the lymphatic origin of the sample, but also revealed some unexpected parasitic structures. While a complete identification could not be made on a few sections, the morphologic and epidemiologic evidence suggested Dirofilaria repens. The mass was surgically removed and identified as an adenolymphocele, which appears to be a new localization of dirofilariasis in humans. This case emphasizes the utility of FNA in diagnosing such unexpected findings without the use for exploratory surgery.