title: Chronic wuchereriasis presenting as a vaginoperineal fistula: report of a case with aspiration cytologic diagnosis.
abstract: BACKGROUND
  Filariasis is often an occult disease with myriad presentations. Cytology has an established role in diagnosing clinically unsuspected cases.
  
  
  METHODS
  A 20-year-old female presented with recurring perineal ulcers, vaginal discharge and inguinal lymphadenopathy. Radiology revealed a vaginoperineal fistula. Fine needle aspiration (FNA) of the ulcer bed and smears prepared from the ulcer discharge showed an adult, gravid, female filarial worm and unsheathed larvae. Similar microfilariae were also seen in FNA smears from inguinal lymph nodes. The atypical clinical presentation and unusual parasite morphology posed initial difficulties in characterization of the microfilarial species.
  
  
  CONCLUSIONS
  This case report highlights the morphologic clues to the dif ferential diagnosis offilarial species on cytologic specimens. Chronic wuchereriasis presenting as a vaginoperineal fistula has not been reported previously.
authors.affiliation: Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. prashant_sharma@msn.com
authors.forename: Prashant
authors.initials: P
authors.lastname: Sharma
authors.forename: Neeta
authors.initials: N
authors.lastname: Kumar
authors.forename: Parul
authors.initials: P
authors.lastname: Jain
authors.forename: Renu
authors.initials: R
authors.lastname: Gur
authors.forename: Shyama
authors.initials: S
authors.lastname: Jain
mesh_terms: D000328:Adult; D000818:Animals; D044963:Biopsy, Fine-Needle; D002908:Chronic Disease; D005260:Female; D005368:Filariasis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008842:Microfilariae / Q000302:isolation & purification; D010502:Perineum; D014624:Vaginal Fistula / Q000469:parasitology* / Q000473:pathology; D014957:Wuchereria / Q000302:isolation & purification*