the disease is endemic all over india especially in uttar pradesh , bihar , jharkhand , andhra pradesh , orissa , tamil nadu , kerala and gujarat .
there are at least six million attacks of acute filarial disease per year and 45 million persons are currently having one or more chronic filarial lesions .
. conventional mode of diagnosis of filariasis is by demonstration of microfilaria in peripheral blood smear . despite high incidence
, it is infrequent to find microfilariae in fine needle aspiration cytology ( fnac ) smears and body fluids .
the literature contains a few reports of microfilariae found in various locations including thyroid nodule , skin and soft tissue swelling , epididymis , breast,[268 ] salivary gland , cervicovaginal smear , ovarian cyst , urine , lymph node , and effusion fluids .
the aim of present study was to assess the role of fnac in diagnosis of filariasis in asymptomatic patients having superficial lumps .
the study was conducted at the department of pathology in collaboration with the departments of medicine and surgery at b.r.d . medical college , gorakhpur during a period of two years i.e. 2006 - 2007 .
a total of 250 cases , with age ranging from 15 - 80 years , having swellings at various sites were included in the present study .
aspiration was made by technique of martin and ellis . in case of cystic lesions ,
cyst content was aspirated and smears prepared from cyst fluid after cytocentrifugation were studied along with the aspiration performed from cyst wall .
these smears were wet fixed immediately in 95% alcohol and stained by hematoxylin and eosin and papanicolaou stain .
this study was conducted on 24 cases of filariasis diagnosed on routine fnac material from various sites . out of these 24 cases ,
maximum cases of filariasis were reported in breast swelling ( eight cases ) , followed by lymph nodes ( six cases ) , scrotal swellings ( four cases ) , thyroid swellings ( three cases ) , soft tissue swellings ( two cases ) and ascitic fluid ( one case ) . clinical presentations of these cases were variable which included swelling , pain , fever and erythema [ table 1 ] . showing clinical profile , cytological findings and associated conditions of 24 cases smears revealed sheathed microfilariae , tails of which were free from nuclei and many had graceful curves .
thick and thin blood smear examination of nocturnal venous blood revealed microfilariae of wuchereria bancrofti in three out of 24 cases .
microscopic examination of breast swellings showed sheathed microfilaria along with few groups of benign ductal epithelial cells , myoepithelial cells , bare nuclei , few fragments of fibrofatty tissue and inflammatory cells comprising of eosinophils and neutrophils [ figure 1 ] .
two cases of breast lumps showed epithelioid non - necrotising granuloma without giant cells and plasma cells .
fnac smear of breast swelling showing sheathed microfilaria along with inflammatory cells thyroid aspirates revealed few groups of follicular cells in the background of colloid . in between follicular groups ,
aspirate from scrotal swelling showed numerous coiled and uncoiled sheathed microfilariae along with neutrophils , eosinophils and few lymphocytes [ figure 2 ] .
fnac smear of scrotal swelling showing sheathed microfilariae along with polymorphs , macrophages and eosinophils lymph node aspirates showed sheathed microfilariae in the background of mixed population of lymphoid cells comprising of mature lymphocytes , centrocytes , centroblasts , dendritic cells and few eosinophils .
cytological findings of soft tissue swellings showed microfilariae along with neutrophils , eosinophils and granular debris .
cell adherence of inflammatory cells and macrophages to microfilariae was seen in three out of 24 cases .
filariasis is a major public health problem in tropical countries , including india . in endemic areas like eastern part of uttar pradesh ,
a majority of infected individuals in filarial endemic communities were asymptomatic . in the present study maximum cases ( eight out of 24 cases )
many authors have reported microfilariae in breast lumps by fnac smears.[2468 ] aspirates from lymph nodes ( five out of 24 ) , demonstrated microfilariae in a background of reactive lymphoid cells .
the lymphatic vessels of spermatic cord appear to be common and perhaps the principal site of adult wuchereria bancrofti in men with asymptomatic microfilaremia .
occurrence of living w bancrofti in scrotal area of men was demonstrated by noroes et al .
two cases of soft tissue swellings and one case of ascitic fluid showed microfilaria along with inflammatory cell including eosinophils , lymphocytes and macrophages .
out of 24 cases showing microfilariae in fnac smear examination , blood eosinophilia was present in eight cases , of which microfilaremia in nocturnal venous blood smear examination was observed in three cases only .
findings are consistent with observation made by others , who reported that filariasis can exist without microfilaremia .
significant adherence of inflammatory cells and macrophages to microfilariae was present in three out of 24 cases .
despite high incidence of filariasis , microfilaria in fine needle aspiration cytology is not a very common finding . careful screening of fnac smears
undoubtedly the demonstration of parasite , in aspirate , play a significant role in recognition of disease and institution of specific treatment , thus obviate the severe manifestations of lymphatic filariasis .
 background : filariasis is a major health problem in tropical countries including india . 
 fine needle aspiration cytology plays an important role in prompt recognition of disease.aim:to assess the role of fine needle aspiration cytology ( fnac ) in diagnosis of filariasis at all possible sites.materials and methods : total 250 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology.results:out of 250 cases , 24 cases of filariasis were detected which include breast lumps ( 8 cases ) , lymph nodes ( 6 cases ) , scrotal swellings ( 4 cases ) , thyroid swellings ( 3 cases ) , soft tissue swellings ( 2 cases ) and ascitic fluid ( 1 case ) . 
 eosinophilia was present in 8 out of 24 cases with a percentage ranging from 12 - 24% . 
 significant adherence of inflammatory cells and macrophages to microfilariae was present in 3 out of 24 cases.conclusions:in endemic areas , it should be considered one of the differential diagnoses of a superficial swelling . 
 careful screening of fnac smears help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment . 
Introduction
Materials and Methods
Results
Discussion
Conclusions