Microfilariasis of the breast mimicking malignancy

Abstract

We report a 65-year-old female who presented with a 3.5×3 cm retro-areolar lump of the right breast with associated right axillary lymphadenopathy, mimicking breast cancer. Mammography showed a well-defined mass in the central quadrant of the right breast. Fine needle aspiration cytology from the breast lump demonstrated many microfilariae of Wuchereria bancrofti.

A 65-year-old female from Bihar presented with a complaint of a painless lump in the right breast for the last one year. On examination, a 3.5 × 3 cm firm, mobile, retroareolar lump was found in the right breast, along with a 1 × 1 cm single, firm, mobile lymph node in the right axilla. No skin change, nipple retraction, or peau d’orange was seen. Mammography showed a well-defined mass in the central quadrant of the right breast [Figure 1]. A clinical suspicion of breast carcinoma was considered, but fine-needle aspiration cytology (FNAC) from the lump revealed numerous sheathed microfilariae of Wuchereria bancrofti with rounded anterior and tapering posterior ends with elongated terminal nuclei, in the background of inflammatory cells [Figure 2]. No malignant cells were identified. FNAC from the right axillary lymph node showed reactive lymphocytosis. A midnight peripheral blood sample failed to show any microfilaria, even after diethylcarbamazine citrate (DEC) provocation. A diagnosis of occult microfilariasis of the right breast was made.

Figure 1.

Mammography of the right breast (mediolateral oblique view) showing a well-defined mass in the central quadrant without any microcalcification

Figure 2.

Photomicrograph showing a microfilaria of Wuchereria bancrofti with rounded anterior and tapered posterior ends, in the background of inflammatory cells (MGG ×40)