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Filariasis in axillary lymph node.

L S Chen1, P S Wong1, K N Leong1

  • 1Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia.

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A case study identified adult filarial worms in an axillary lymph node of an asymptomatic Indian woman. This incidental finding during breast cancer screening highlights filariasis as a potential cause of lymphadenopathy.

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Area of Science:

  • Medical Parasitology
  • Human Pathology
  • Diagnostic Imaging

Background:

  • Filarial worm infestation can present with varied clinical manifestations.
  • Lymphadenopathy is a common clinical sign, but parasitic causes are often overlooked in non-endemic regions.
  • Incidental findings on imaging can lead to the diagnosis of unexpected conditions.

Purpose of the Study:

  • To report a rare case of adult filarial worms detected in an axillary lymph node.
  • To highlight the importance of histopathological examination in diagnosing parasitic infections.
  • To emphasize the role of incidental imaging findings in identifying asymptomatic parasitic infestations.

Main Methods:

  • Mammography for breast screening.
  • Fine needle aspiration cytology (FNAC) of axillary lymph node.
  • Histopathological examination of excisional biopsies of breast lump and axillary lymph node.
  • Microscopic identification of parasitic structures.

Main Results:

  • Mammography revealed microcalcifications and axillary lymphadenopathy.
  • FNAC suggested reactive lymphadenitis.
  • Histopathology of the breast lump showed fibrocystic disease.
  • Histopathology of the axillary lymph node revealed reactive lymphoid hyperplasia with calcified, serpiginous tubular bodies consistent with non-viable filarial worms.
  • Final confirmation of adult filarial worm presence.

Conclusions:

  • Adult filarial worms can be incidentally found in axillary lymph nodes of asymptomatic individuals.
  • Histopathology is crucial for diagnosing parasitic infections presenting as lymphadenopathy.
  • Filarial infestation should be considered in the differential diagnosis of lymphadenopathy, even in the absence of typical symptoms.