|Year : 2019 | Volume
| Issue : 3 | Page : 270-271
Liquid-based cytological diagnosis of achylous unilateral bancroftian pleural effusion: An uncommon presentation of a common problem
Department of Pathology, Sri Devaraj URS Medical College, Kolar, Karnataka, India
|Date of Web Publication||15-May-2019|
Department of Pathology, Sri Devaraj URS Medical College, Tamaka, Kolar, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Das S. Liquid-based cytological diagnosis of achylous unilateral bancroftian pleural effusion: An uncommon presentation of a common problem. Med J DY Patil Vidyapeeth 2019;12:270-1
|How to cite this URL:|
Das S. Liquid-based cytological diagnosis of achylous unilateral bancroftian pleural effusion: An uncommon presentation of a common problem. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2019 May 25];12:270-1. Available from: http://www.mjdrdypv.org/text.asp?2019/12/3/270/258207
Filariasis is a common parasitic disease of the tropical region, and most cases of cytologically diagnosed filariasis are clinically unanticipated. Microfilaria, ova, and fragments of adult worm of Wuchereria bancrofti, in exfoliative as well as aspiration cytology, have been reported and are useful in cytological detection of bancroftian filariasis.
Common methods of diagnosis of filariasis in this country are by demonstration of microfilaria in stained or unstained blood films, circulating filarial antigen detection and demonstration of organism in histopathological sections. Fluid cytology or fine-needle aspiration cytology is rarely applied for routine diagnosis.
Diagnosis of filariasis in cytological smears can also be made by the presence of fragments of adult female or male worms and ova of the filarial organism with or without simultaneous presence of microfilaria. The presence of ova and adult worms of filarial organism in cytological smears may or may not be associated with simultaneous presence of microfilaria.,
Adult female worms were the more common finding than male worm, in most of the studies and in reported cases; in addition, most of the female worms detected in smears were gravid containing microfilaria or embryonated ova within their body cavities as well as outside.,,
As the parasites circulate in the lymphatic and vascular systems, appearance of filarial organism in tissue fluids and exfoliated surface material probably occurs due to conditions causing lymphovascular obstruction, resulting in extravasations of blood and release of microfilariae., Such aberrant migration to these dead-end sites is probably determined by local factors, such as lymphatic blockage by scars, or tumors, and damage to the vessel wall by inflammation, trauma, or stasis.,
Microfilariae have been detected in association with metastatic malignant cells in pleural fluid, peritoneal fluid, and pericardial fluid. In the present study, one case of microfilaria was detected in association with metastatic adenocarcinoma in the pleural fluid. Serous cavity effusion such as pleural effusion can be primarily caused by filarial infection, and a search for microfilaria in pleural fluid smears especially in cases of recurrent effusions can be very rewarding if tuberculosis and malignancy are remote possibility.
Liquid-based cytology (LBC) has numerous advantages over the conventional cytology. The main advantages include:
- uniform collecting procedure.
- standardized sample processing techniques.
- availability of residual clinical material for further studies and also for applying ancillary techniques wherever possible.
Although LBC has revolutionized cervical cancer screening worldwide, a major drawback of LBC has been its lack of universal accessibility, particularly with regard to the rural and resources constraint set up like us.
One suggested measure to overcome this drawback is to consider the feasibility of having centrifuged LBC (C-LBC), which has shown promising results in exfoliative cytology of oral mucous.
More such studies are required to conform the diagnostic efficacy of C-LBC with regard to fluid cytology.
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