Cytodiagnosis of Visceral Leishmaniasis in Lymph Node Aspirate: A Rare Case Report

Leishmaniasis is a parasitic disease caused by leishmania species. There are three main forms of the disease: Cutaneous, Mucocutaneous and Visceral Leishmaniasis (VL). VL with lymphadenitis is an uncommon presentation. Visceral leishmaniasis is usually diagnosed by identification of parasite Leishman Donovan (LD) bodies in bone marrow aspirates but cytological diagnosis of VL on lymph node aspirates has rarely been reported. This is a case report of a 37-year-old male presenting with multiple isolated cervical lymphadenopathy for three months. The lymphadenopathy was initially suspected to be tubercular in nature which is highly prevalent in India and lymphadenopathy is its common presenting feature, but on Fine Needle Aspiration Cytology (FNAC) of the node, multiple leishmania parasites were identified. Lymphadenopathy due to leishmaniasis is rare in India and most of the previous cases reported have association of leishmaniasis with Human Immunodeficiency Virus (HIV) infection. But this case is unusual as it is not associated with HIV infection. Thus, leishmaniasis should be included in the differential diagnosis of lymphadenopathy, especially in patients coming from endemic region. Cytology can be very helpful in such cases for early diagnosis and further management.