International Journal of Research in Medical Sciences | October 2015 | Vol 3 | Issue 10 Page 2889 International Journal of Research in Medical Sciences Chordiya AP et al. Int J Res Med Sci. 2015 Oct;3(10):2889-2991 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Microfilaria in malignant pleural effusion: an unusual incidental finding or causative association? Anandkumar P. Chordiya*, Sonali S. Datar, Amit K. Agrawal, Rasika U. Gadkari, Anuradha V. Shrikhande INTRODUCTION Filaria, a vector‑borne disease, is common in tropical countries like India. Wuchereria bancrofti is the most widespread of the filarial organisms, infecting man. The parasite is endemic in both urban and rural areas of India. 1 Filariasis presents acutely with fever, adenolymphangitis, funniculitis, epididymitis or orchitis. Lymphoedema, hydrocele, elephantiasis and chyluria are features of chronic infection. 2 Microfilaria are not just confined to the lymphatic system but are also associated with other organs, subcutaneous tissues and serous cavities like pleura and pericardium. 3 Microfilaria has been observed as coincidental findings with other inflammatory conditions, primary malignant tumors and in metastatic deposits. 4 Our case was rare coexistence of microfilaria in haemorrhagic pleural effusion with occult primary. CASE REPORT A 60 year old male chronic smoker presented with left sided chest pain since 1 month, shortness of breath on exertion, cough with expectoration and generalized weakness since last 10 days. During his hospital stay, he developed swelling over left infrascapular region. Patient had no past history of pulmonary tuberculosis. On examination patient was average built. No any pallor, cyanosis, icterus or clubbing seen. He was tachycardiac and tachypenic at rest. Respiratory system examination revealed features of left sided pleural effusion. Other system examinations were not contributory. Haematological investigation revealed haemoglobin of 11.9 gm% while total and differential leucocyte count was within normal range. There was no eosinophilia. ABSTRACT Lymphatic filariasis is common in tropical countries and is endemic in India. Filaria has a wide spectrum of presentation. Filarial lung involvement is usually in the form of tropical pulmonary eosinophilia with pulmonary infiltrates and peripheral eosinophilia. Filariasis presenting with pleural effusion is an unusual presentation. Malignancy in association with filarial pleural effusion is extremely rare and its role in tumorigenesis is controversial. In this context, we hereby report a case of 60 year old male, chronic smoker, who presented with left sided chest pain, cough, breathlessness, generalized weakness and swelling over left infrascapular region. Pleural fluid cytology repeated thrice due to degenerative changes, finally revealed malignant cells along with microfilaria. FNAC from left infrascapular swelling showed cytological features suggestive of metastatic deposits of Adenocarcinoma. Keywords: Microfilaria, Malignancy, Pleural effusion, Tumorigenesis Department of Pathology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India Received: 24 August 2015 Revised: 02 September 2015 Accepted: 07 September 2015 *Correspondence: Dr. Anandkumar P. Chordiya, E-mail: drapc6888@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150851