Filariasis in axillary lymph node

A case of adult filarial worms detected in an axillary lymph node of an asymptomatic patient. A 64 year-old Indian female underwent a mammogram and was incidentally found to have punctate microcalcifications in the upper outer quadrant of the left breast with left axillary lymphadenopathy. She has underlying hypertension and diabetes mellitus on oral medications. She has no family history of breast malignancy. Fine needle aspiration of the left axillary lymph node was suggestive of reactive lympha-denitis. Histopathological examination of excisional biopsy of left breast lump showed fibrocystic disease; no evidence of malignancy was detected whereas excisional biopsy of left axillary lymph node showed reactive lymphoid hyperplasia, featuring variably sized lymphoid follicles with intact mantle zone. No expansion of marginal zone was noted. Occasional pigment-laden macrophages were seen. One of the lymph node showed presence of calcified serpinginous tubular bodies, in keeping with non viable parasite organisms with intact outlines of the structures. There were no eosinophilic infiltrates. The possibility of filarial infestation was suspected. Histopathological sample was sent for further identification and confirmed the presence of adult filarial worm.