Adult filarial worm in the aspirate from a breast lump mimicking fibroadenosis

Filariasis is major public health hazard particularly in tropical countries like India. The presence of microfilaria using fine needle aspiration cytology has been reported from various sites. However, the presence of the adult gravid filarial worm with a surrounding host response has rarely been reported on breast aspirates. Here, we report a unique case in which aspiration cytology from a breast lump clinically suspicious of fibroadenosis of the breast, showed adult filarial worms with numerous microfilariae and a granulomatous inflammatory host response. The filarial worm appears to be ubiquitous in endemic areas, and the presence of an unexplained granulomatous lesion in breast should prompt a careful consideration of the filarial etiology in our country. Therapy with diethylcarbamazine, albendazole, and antibiotics are sufficient for treatment of this type of lesion.