CT findings in involvement of the paranasal sinuses by lepromatous leprosy.

Abstract

The role of nasal infection in the transmission of leprosy has been extensively studied. Leprosy can affect the paranasal sinuses due to mucosal continuity and bacillaemia. This prospective study was performed on 25 untreated patients with lepromatous leprosy. 5 mm contiguous axial and coronal CT sections of paranasal sinuses, on soft tissue and bone windows, were obtained in all patients. Each sinus was examined for mucosal thickening, soft tissue densities and bony outlines. Representative biopsies were taken from ethmoid sinus to confirm the radiological diagnosis in 12 patients with multiple paranasal sinus involvement. Ethmoid aircells were involved in 20 patients (80%). Maxillary, frontal and sphenoid sinuses showed abnormalities in 12, four and three patients, respectively. The ethmoid biopsy showed involvement by lepromatous leprosy in seven of 12 patients (58.3%). Involvement of paranasal sinuses is common in lepromatous leprosy and is of considerable epidemiological significance.

Chronic rhinosinusitis in ex-lepromatous leprosy patients with atrophic rhinitis

“…2,7,8 On the other hand, a previous study of treated lepromatous leprosy patients found septal perforation in 47.3 per cent (18 of 38), suggesting that, in cases of persistent infection, cartilage destruction may continue even after the treatment of leprosy. Lepromatous leprosy is the severest type of leprosy, so we presumed that massive chronic granulomatous infection had caused these scar formations.…”

“…7,8 Similarly, the ethmoidal sinuses have been reported to be the most commonly involved sinuses (55.2 per cent) in treated lepromatous leprosy patients; furthermore, 33.3 per cent of these patients have had persistent acidfast bacilli infection. Ex-leprosy patients are sometimes exposed to antibiotics for management of the complications of leprosy.…”

Leproma Presenting as a Nasal Cavity Mass

“…Ethmoidal sinuses are affected in 33% to 80% of patients, maxillary sinuses in 48% to 55%, sphenoid sinuses in 12% to 20%, and the frontal sinuses in 5% to 30%. 8 The diagnosis of leproma in the nasal cavity is confirmed by histopathology. Hematoxylin and eosin stain reveals infiltration of foamy histiocytes, plasma cells, and neutrophil.…”

A Case of Secondary Atrophic Rhinitis With Hansen’s Disease

“…10 Depending upon the host immune response, nasal symptoms of leprosy may include epistaxis, gross nasal deformity and destruction. Patient may complain of anosmia and nasal obstruction.…”

“…10,11 This clinical report of a case of secondary atrophic rhinitis with Hansen's disease is aimed at showing the nasal finding in leprosy along with its treatment and reconstruction of the nose.…”