Embryonated eggs of filarial worm with granulomatous reaction: An unusual finding!

Abstract

Filariasis is not uncommon in the Indian subcontinent. It is detected most commonly by the presence of microfilaria in the peripheral blood smear with associated eosinophilia and sometimes in the fine needle aspirates performed from various sites with strong clinical suspicion. The adult worm resides in the lymphatic channels causing inflammation and fibrosis. Clinically, this presents as lymphoedema usually in the dependent parts of the body. Filariasis presenting as subcutaneous or lymph node swellings is uncommon and presence of a granulomatous reaction in response to the filarial worm has hardly been reported. Here we report a case of 14-year-old boy presenting with a painless swelling on the flexor aspect of left arm. Fine needle aspirate cytology revealed numerous embryonated eggs, larvae and a segment of gravid female filarial worm with granulomatous reaction. There was no evidence of lymphoedema or microfilaremia.