Fine needle aspiration cytology of leprous neuritis.
OBJECTIVE
To document the cytomorphologic features of leprous neuritis and their correlation with bacterial density.


METHODS
A partly retrospective, partly prospective study of the fine needle aspiration cytology of enlarged nerves in leprosy. Cytomorphologic features of nerve aspirates from 28 patients were studied. May-Grünwald-Geimsa and Ziehl-Neelsen staining methods were employed.


RESULTS
Five cytomorphologic patterns were observed in smears of nerve aspirates in 19 group I patients with concurrent skin and nerve lesions: (1) inflammation composed of epithelioid cell granulomas (5), bacillary index (BI) = 0; (2) epithelioid cell granulomas with necrosis (5), BI = 0-1+; (3) acellular necrosis (5), BI = 0-4+; (4) macrophage granuloma (3), BI = 5-6+; and (5) granulation tissue (1), BI = 1+. In 9 group II patients with pure neuritic leprosy, 3 patterns were seen: (1) epithelioid cell granulomas (5), BI 0-6+; (2) epithelioid granulomas with necrosis (1), BI = 0; and (3) acellular necrosis (3), BI = 0-6+.


CONCLUSIONS
The entire spectrum of leprosy is seen in nerve aspirates. Necrosis is often a prominent feature. Recognition of the range of cytomorphologic patterns and their correlation with BI contribute to accurate calibration of the disease in nerves, resulting in appropriate choice of treatment.
Singh
Navjeevan
N
Cytology Section, Department of Pathology, University College of Medical Sciences, Guru Tegh Bahadur Hospital, Delhi 110 095, India.
Malik
Abha
A
Arora
Vinod K
VK
Bhatia
Arati
A
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006099:Granuloma / Q000382:microbiology / Q000473:pathology; D006801:Humans; D015441:Leprosy, Tuberculoid / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000302:isolation & purification / Q000472:pathogenicity / Q000502:physiology; D009443:Neuritis / Q000382:microbiology / Q000473:pathology*; D010525:Peripheral Nerves / Q000382:microbiology / Q000473:pathology*; D011446:Prospective Studies; D012189:Retrospective Studies