Diagnostic utility of fine needle aspiration cytology of sensory cutaneous nerve in leprosy

Authors

  • Reena Naik MBBS, DNB (Pathology), Assistant Prof in Pathology, Govt Medical College (LSLAMMC), Raigarh, Chhattisgarh
  • Dilip Kumar Sa MD (Skin &VD), Asso Prof of Skin &VD , Govt Medical College(LSLAMMC), Raigarh, Chhattisgarh
  • Kishori Moni Panda MD (Pathology), Prof of Pathology, Govt Medical College(LSLAMMC), Raigarh, Chhattisgarh

Keywords:

Peripheral neuropathy, Fine-needle aspiration cytology (FNAC), Hansen’s disease, lepra bacilli, sensory cutaneous nerve.

Abstract

Background: Peripheral neuropathy is a central feature of leprosy. Intraneural inflammation caused by M. leprae is the morphological hallmark of this disease, FNAC of sensory cutaneous nerve has proved to be a valuable diagnostic tool.

Materials and methods: The data of patients with sensory cutaneous nerve involvement were retrieved from our record for the period from Nov 2014 to Sept 2015. The hematoxylin and eosin (H and E)- and May-Grünwald-Giemsa (MGG)-stained slides were screened for Schwann cells, granuloma, and necrosis. Modifi ed Ziehl-Neelsen (ZN)-stained smears were searched for single lepra bacilli and globi.

Results: Twenty-five sensory cutaneous nerves were aspirated. Out of which 19 yielded diagnostic aspirate. Five cytologic pictures were seen - epithelioid cell granulomas (6), epithelioidcell granulomas with necrosis (3);necrosis + lepra bacilli (4); only lepra bacilli (2); and lymphocyte & macrophage infiltrate (4).Following the Ridley-Jopling classification, in our study there were 9 cases of TT, 4 of BT-TT, 1 of BB, 2 of BL, and 3 of LL.

Conclusion: FNAC of sensory cutaneous nerve is useful in diagnosis and classification of leprosy on the R-J scale.

DOI: 10.21276/APALM.1178

References

1. Alexander J., Mc Adam, Milner DA, Sharpe AH. Infectitious diseases. In: Kumar, Abbas, Aster editors. Robbins and Cotran Pathologic basis of disease. 9 th edition Saunders/Elsevier, Philadelphia 2014:377
2. E. Wilder-Smith, "Diagnosis of pure neuritic leprosy," Neurological Journal of South East Asia 2002;7: 61—63
3. Prasoon D, Mandal SK, Agrawal P. Sensory cutaneous nerve fine-needle aspiration in Hansen's disease: A retrospective analysis of our experience. J Cytol 2015;32:170-75.
4. Singh N, Bhatia A, Gupta K, Ramam M. Cytomorphology of Leprosy across the Ridley Jopling spectrum. Acta Cytol 1996;40:719-23.
5. Jopling WH, McDougall AC. Definition, epidemiology and world distribution. In: Jopling WH, McDougall AC, editors. Handbook of Leprosy. 5 th ed.CBS Publishers, New Delhi 1996:1.
6. Noordeen SK. The epidemiology of leprosy. In: Hastings RC, Opromolla DVA editors.Leprosy 2 nd ed. Churchill Livingstone, London 1994:29-45.
7. WHO Expert committee on leprosy 1988 Sixth report. Technical Report Series 768, Geneva: World Health Organization.
8. Ridley DS, Jopling WH. Classification of leprosy according to immunity: A five group system. Int J Lepr 1966;34:255-73.
9. Ridley MJ. The cellular exudate: Mycobacterium leprae relationship and the critical reading of slit smears. Lepr Rev 1989;60:229-40.
10. Singh N, Arora VK, Ramam M. Nodular lepromatous leprosy: Report of a case diagnosed by FNA. Diagn Cytopathol 1994;11:373-5.
11. Siddaraju N, Yaranal PJ, "Use of fine needle aspiration cytology in leprotic lesions: a report of 4 cases," Acta Cytologica 2007;51: 235—238
12. Theuvenet WZ, Miyazaki N, Roche PW, and Shrestha I, "Cytological needle aspiration of the nerve for the diagnosis of pure neural leprosy," International Journal of Leprosy 1993; 61:597—599
13. Jayaseelan E, Shariff S, Rout P, "Cytodiagnosis of primary neuritic leprosy," International Journal of Leprosy and Other Mycobacterial Diseases 1999;67: 429—434
14. Siddaraju N, Sistla SC, Singh N et al., "Pure neuritic leprosy with nerve abscess presenting as a cystic, soft tissue mass: report of a case diagnosed by fine needle aspiration cytology," Diagnostic Cytopathology 2009;37:355-8
15. Vijaikumar M, D'Souza M, Kumar S, Badhe B, "Fine needle aspiration cytology (FNAC) of nerves in leprosy," Leprosy Review 2001;72:171—178
16. Singh N, Malik A, Arora VK, Bhatia A, "Fine needle aspiration cytology of leprous neuritis," Acta Cytologica 2003;47: 368—372
17. Rao IS, Singh MK, Datta SK, Pandhi RK, Kapila K. "Utility of fine-needle aspiration cytology in the classification of leprosy," Diagnostic Cytopathology 2001;24:317—321
18. Prasad PV, George RV, Kaviarasan PK, Viswanathan P, Tippoo R, Anandhi C, "Fine needle aspiration cytology in leprosy," Indian Journal of Dermatology, Venereology and Leprology 2008;74:352—356
19. Jaswal TS, Jain VK, Jain V, Singh M, Kishore K, Singh S. "Evaluation of leprosy lesions by skin smear cytology in comparison to histopathology," Indian Journal of Pathology and Microbiology 2001;44:277—281

Downloads

Published

07-04-2017

Issue

Section

Original Article

How to Cite

1.
Diagnostic utility of fine needle aspiration cytology of sensory cutaneous nerve in leprosy. Ann of Pathol and Lab Med [Internet]. 2017 Apr. 7 [cited 2025 Dec. 13];4(2):A157-162. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1178