The Histopathology of Tongue Lesions in Leprosy
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A histopathological study of the tongue lesions in 8 cases of lepromatous leprosy is presented.The salient histopathological changes in these lesions are described and the implication of the findings discussed.Keywords:
Histopathology
Histopathology
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In the present study, the frequency of histopathological reports of leprosy carried out in the last 22 years at the Fst Chair of Pathology (Medical School, U. N.C) was determined. Our findings on the frequency of pure forms of leprosy agree with those reported by the O.M.S. On the contrary, that was not the case with respect to reactive forms, since the phenomenon of Lucio and Alvarado was more frequent in endemic zones.
Histopathology
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Histopathology
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Open thyroid biopsies from seven patients of bacilliferous leprosy were studied for leprous granuloma or amyloid deposition. None of the patients had clinical evidence of thyroid involvement. Histopathology did not reveal any specific abnormality.
Histopathology
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A histopathological study of the tongue lesions in 8 cases of lepromatous leprosy is presented.The salient histopathological changes in these lesions are described and the implication of the findings discussed.
Histopathology
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Introduction: Leprosy is one of the leading causes of physical disabilities contributing to intense social stigma resulting in human discrimination. This chronic infectious disease caused by Mycobacterium leprae principally affects skin and peripheral nerve. It can also include muscle, eyes, bones, testis and internal organs. Histopathology study and bacillary index is important in understanding the disease progression, diagnosis, varied manifestation and complications. Method: All cases attending the skin OPD were examined clinically and skin biopsy specimen was obtained from clinically diagnosed cases of Leprosy and stained with Hematoxylin& Eosin and modifiedFiteFaraco (AFB). The clicical diagnosis correlated with histopathology in all 100 cases. Result: The age of the patients was ranged from 4 to 80 years. The male to female ratio patients was 3 to 1. Borderline Tuberculoid was the most common presentation. Highest parity was observed in BT and Histioid leprosy. Clinico- histopathological agreement was seen in 76(76%) cases. Conclusion: The clinical and histopathological features along with bacteriological index are useful than any single parameter in arriving definitive diagnosis and classification of the leprosy.
Histopathology
Mycobacterium leprae
Skin biopsy
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Histopathology
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Objectives: The objectives of the study were (1) to study the fine-needle aspiration cytology (FNAC) features of skin lesions of leprosy, (2) to determine the agreement between FNAC and histopathology to classify leprosy into different groups of the spectrum, and (3) to determine the sensitivity and specificity of FNAC to classify leprosy into different groups of the spectrum against the gold standard of histopathology. Materials and Methods: All newly diagnosed cases of leprosy who attended the outpatient department of dermatology and venereology of a tertiary referral center during the 16 months study period were included in this cross-sectional study. Based on FNAC and histopathology, patients were classified into different groups of the spectrum. Agreement between FNAC and histopathology to classify leprosy was determined by Kappa statistics. Sensitivity and specificity of FNAC to classify leprosy were determined against the gold standard of histopathology. Results: All the 47 study participants had histopathology features of leprosy. FNAC could obtain adequate aspirate in 30 patients (63.8%), who were considered for further analysis. There was moderate agreement (76.6%) between classification of leprosy by FNAC and histopathology on Kappa statistics (Kappa value 0.766). FNAC showed 80–100% sensitivity and 84–100% specificity to classify leprosy against the gold standard of histopathology. Limitation: Small sample size. Conclusion: When adequate aspirate is obtained, FNAC could serve as a useful tool in classification of leprosy.
Histopathology
Gold standard (test)
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Patients presenting with ‘pure neural leprosy’ poses a diagnostic challenge as several other peripheral neuropathies present with similar clinical features. It is common for patients presenting with peripheral neuropathy symptoms to seek treatment at the tertiary care hospitals. We report histopathological findings in 113 referred cutaneous nerve biopsies from patients suspected with ‘Pure neural leprosy’ at two teaching tertiary care hospitals in Mumbai, during the period 2008–2015. Confirmatory evidence of leprosy in histopathology was found in 83 (73.5%) cases and 35 (42.2%) among them scored positive for Acid-Fast Bacilli (AFB). Among the confirmed cases, the entire spectrum of leprosy was seen with predominance of Borderline Leprosy to Lepromatous Leprosy (BL-LLs) lesions (37.3%) followed by Borderline Tuberculoid (BT) (31.3%), Mid Borderline (BB) (15.7%) and Indeterminate type (4.8%). In the remaining 39 cases (34.5%), the nerves showed moderate to severe fibre loss but no specific infiltrating cells or AFB. Thus a conclusive diagnosis of leprosy could not be made. Conclusion: Neural histopathology in almost 35% of suspected ‘pure neural cases’ did not conform to leprosy. The present study underscores the importance of histopathology in establishing a firm diagnosis and classification, and draws attention to appropriate selection of nerve for biopsy.
Histopathology
Nerve biopsy
Skin biopsy
Tuberculoid leprosy
Mycobacterium leprae
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Proof of leprosy as a cause of ‘pure neural leprosy’ needs histological evidence, which is often sought in the affected peripheral nerves. Obtaining a nerve biopsy may not always be practicable. Thus in this study, the histopathology of the involved nerve and the overlying skin were compared in 32 cases of ‘pure neural leprosy’ in order to determine the utility of skin biopsy in diagnosing leprosy. Evidence of leprosy was present in all, except one nerve biopsy (97%) and in 14/32 (44%) skin biopsies from skin overlying the biopsied nerve. One noteworthy finding is that in nerves showing BL-LLs leprosy, which formed a major group (59%), only 26% of biopsies of the overlying skin showed evidence of leprosy. In nerves showing BT pathology, 67% of the biopsies of overlying skin showed evidence of leprosy. Conclusion: Histopathological examination of the overlying skin compares poorly with the affected cutaneous nerve and is of limited diagnostic value, particularly at the lepromatous end of the spectrum.
Histopathology
Skin biopsy
Nerve biopsy
Cutaneous nerve
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