title: Pure neuritic leprosy with nerve abscess presenting as a cystic, soft tissue mass: report of a case diagnosed by fine needle aspiration cytology.
abstract: Pure neuritic leprosy (PNL) with nerve abscess manifesting as a huge, cystic, soft tissue mass is highly uncommon. Fine needle aspiration cytology can serve as an important initial diagnostic modality in such an instance. We report a case of 28-year-old male, who presented with a huge swelling in the lower, medial aspect of the right upper arm. The clinical diagnosis was schwannoma. Fine needle aspiration (FNA) yielded 80 ml of sticky, turbid, pale brown fluid. Cytologic examination revealed abundant, caseous, necrotic material and many degenerated neutrophils in a thin proteinaceous background. Stain for acid fast bacilli (AFB) was negative. Based on an AFB negative, caseous, necrotic material obtained from the soft tissue mass located in the ulnar nerve region, a cytodiagnosis of tuberculoid PNL with nerve abscess was given, and this was confirmed by the subsequent histopathologic examination. Our case emphasizes the major role of minimally traumatic, FNA technique in the diagnosis of rare cases of clinically unsuspected neuritic leprosies.
authors.affiliation: Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. rajusiddaraju@yahoo.com
authors.forename: Neelaiah
authors.initials: N
authors.lastname: Siddaraju
authors.forename: Sarath Chandra
authors.initials: SC
authors.lastname: Sistla
authors.forename: Neha
authors.initials: N
authors.lastname: Singh
authors.forename: Femela
authors.initials: F
authors.lastname: Muniraj
authors.forename: Qutubuddin
authors.initials: Q
authors.lastname: Chahwala
authors.forename: Debdatta
authors.initials: D
authors.lastname: Basu
authors.forename: Surendra
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000038:Abscess / Q000150:complications / Q000473:pathology*; D000328:Adult; D044963:Biopsy, Fine-Needle; D003560:Cysts / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D007918:Leprosy / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009443:Neuritis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D014459:Ulnar Nerve / Q000473:pathology*