An unusual guest in a patient with Hodgkin's lymphoma

Description

A 42-year-old man with chronic intermittent low grade fever and rapidly progressive right cervical swelling was evaluated in the outpatient clinic. The swelling involved the right level III, IV and V cervical region measuring 10x6x3 cm. Fine needle aspiration from the mass revealed many Reed-Sternberg cells and monolobated Hodgkin's cells (figure 1) which were positive for CD15 and CD30 on immunocytochemical analysis of the cell block material; this was further confirmed on excision biopsy of the lymph nodal mass. Bone marrow (BM) aspiration and trephine biopsy were performed as a part of lymphoma staging. Many sheathed microfilariae of Wuchereria bancrofti with a tapering tail free of cell nuclei were seen in the BM aspiration smears; some of these microfilariae were observed to be in close contact with the BM particles (figure 2). Trilineage haematopoesis without eosinophilia or any evidence of infiltration by Hodgkin's lymphoma was...

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