Incidental detection of microfilaria in cyst fluid of Mucinous cystadenocarcinoma of ovary: A rare case report

Abstract

Introduction: Filariasis is a major health problem in certain parts of India. Microfilaria detection on exfoliative and fluid cytology is extremely rare and it is even very rare to find microfilaria coexistent with neoplastic lesions.

Presentation of case: A 45-year-old nulliparous female, who presented with complaints of lower abdominal swelling and pain. Initially, a clinical diagnosis of cystadenoma was made. Ascitic fluid cytology of the patient showed 3-dimensional clusters of cells along with an occasional microfilaria. On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made.

Discussion: Most common cause of lymphatic filariasis is W. bancrofti followed by Brugia species and it affects young adults. The adult form of the filaria lodge in lymph vessels, and due to lymphatic blockage in neoplasms they appear in tissue fluid or on surface material. It is the first case report of microfilaria being detected in ovarian cystic fluid cytology in a patient of Mucinous cystadenocarcinoma of ovary.

Conclusion: Filaria is an incidental finding in most of the cases, hence, cytopathologist should be vigilant and careful screening of all the slides should be done, especially in a country like India, where it is highly endemic.

Keywords: Exfoliative cytology; Microfilaria; Mucinous cystadenocarcinoma.

Fig. 1

Cells arranged in 3D clusters (A; MGG,40X) Microfilaria (B; MGG,40X).

Fig. 2

Grey white to grey brown solid and cystic mass with multiloculated cystic cavities being filled with mucoid material and serous fluid.

Fig. 3

Clusters, nests and single cell pattern of tumor cells with intervening septa (H&E,40X) brown areas. Cystic.

Fig. 4

Necrosis (H&E,10X) and lining of mucinous cyst demonstrating picket fencing (H&E,40X).

Fig. 5

Tumor cells demonstrate mucicarmine positivity (MUC,40X) and are positive for CK-7 (40X).