Microfilariae in Lymph Node Aspirate Associated with Metastatic Gastric Carcinoma

BACKGROUND: Microfilariae of Wuchereria bancrofti inhabit peripheral blood, and nocturnal periodicity is observed in the Indian subcontinent. However, microfilariae have been reported in various tissues and organs by needle aspiration cytology in atypical cases. Occasionally, they were detected in cases with some diseases including malignancy. CASE: A 55-year-old man presented with complaints of weakness, abdominal distention and anorexia for 3 months. He had pain in the upper abdomen, passage of blackish stool and an episode of hemoptysis later on. A provisional diagnosis of gastric carcinoma with cirrhosis and ascites was made. Aspiration cytology of the left supraclavicular lymph node revealed a microfilaria in the background of malignant cells. Biopsy of the antral mass confirmed the diagnosis of gastric carcinoma. CONCLUSION: Detection of a microfilaria with malignant cells in the lymph node aspirates in a case of gastric carcinoma as an incidental finding is being reported for the first time. It may be due to its transmigration along with metastatic emboli in an immunosuppressed state.