Use of Fine Needle Aspiration Cytology in Leprotic Lesions

Siddaraju, Neelaiah; Yaranal, Parasappa Joteppa

doi:10.1159/000325725

Cited by 11 publications

(24 citation statements)

References 3 publications

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“…15 Although skin lesions in leprosy are usually analyzed by slit-skin smears, studies have been conducted to assess the utility of FNAC in lepromatous leprosy, 16 histoid leprosy, 17 reactional and nonreactional states, 3,18,19 and pure neuritic leprosy. 20 We achieved a high degree of accuracy in diagnosing leprosy on cytology and the cytological features reported in this study correlated well with the published literature. Other authors have also achieved similar results, especially in cases of tuberculoid and lepromatous leprosy.…”

Section: Discussionsupporting

confidence: 85%

Modified fine‐needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

Mehdi

Maheshwari

Ansari

et al. 2009

Diagnostic Cytopathology

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Skin infections are commonly assessed by slit skin or scrape methods. Fine-needle aspiration biopsy (FNAB) is highly effective especially with blanching of skin to ensure good yield and reduced bleeding. The aim of this study was to assess usefulness of cytology, especially modified FNAB technique, in diagnosis of leprosy and cutaneous tuberculosis and to identify specific cytological characteristics for diagnosis and classification. The study was conducted on 40 patients-25 cases of leprosy and 15 cases of cutaneous tuberculosis. Smears were prepared using modified FNAB technique, slit skin, and scrape methods (depending on type of lesion). Cytological diagnosis was confirmed by histopathology where the Ridley-Jopling system was used to classify cases of leprosy. A similar attempt was made for diagnosis and classification of leprosy on cytology. Diagnoses rendered by both modalities were compared to assess the efficacy of cytological examination. Cytological diagnosis was made in 23 cases of leprosy and 12 cases of cutaneous tuberculosis. The smears showed good cellularity. A broad division into tuberculoid and lepromatous leprosy could be made fairly accurately on cytology. Maximum agreement among clinical, cytological, and histopathological diagnosis was observed in cases of tuberculoid leprosy. Smears of cutaneous tuberculosis were characterized by epithelioid cell granulomas with caseation. Overall accuracy of diagnosis was 92% in leprosy and 80% in tuberculosis. FNAB is an inexpensive and accurate procedure for diagnosis of leprosy and cutaneous tuberculosis. The modified technique yields good results. However, clinical correlation, acid-fast staining, and culture are essential as they provide valuable supportive information.

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Section: Discussionsupporting

confidence: 85%

Modified fine‐needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

Mehdi

Maheshwari

Ansari

et al. 2009

Diagnostic Cytopathology

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“…[4] It is proved in many studies that FNAC of sensory cutaneous nerve helps in detection of leprotic inflammation especially granulomas and lepra bacilli. [11][12][13][14][15][16][17] Schwann cells arranged in fascicles could be seen along with granulomas. [13] These cytological features of nerve aspirates also helps in the categorization of leprous neuritis along the Ridley-Jopling scale.…”

Section: Discussionmentioning

confidence: 99%

“…[13] These cytological features of nerve aspirates also helps in the categorization of leprous neuritis along the Ridley-Jopling scale. [11,14,15] Vijaikumar et al studied cases with nerve involvement in leprosy and classified leprous neuritis into paucibacillary (PB), borderline borderline (BB), borderline lepromatous (BL), and polar lepromatous leprosy (LL) types. [15] ( Table-5) describes the RidleyJopling classification as given by different authors.…”

Section: Discussionmentioning

confidence: 99%

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

Naik

Kumar²,

Panda³

2017

APALM

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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. 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. Modified 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), epithelioid cell 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.

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“…[7] The differential diagnoses in cytological point of view include soft tissue tumors like schwannoma and neurofibroma, parasitic cyst and sporotrichosis. [1489] Cytologically, cutaneous schwannomas show slender, wavy cells with elongated nuclei. [18] The aspirate in neurofibroma is gelatinous and smears show spindle shaped nerve elements in a mucomyxoid back ground.…”

Section: Discussionmentioning

confidence: 99%

“…There are a significant number of studies and case reports emphasizing the clinical utility of fine needle aspiration cytology (FNAC) in neuritic leprosy. [12345] We present a short series of five PNLs presenting as nerve abscess to highlight the clinical utility of FNAC.…”

Section: Introductionmentioning

confidence: 99%

Fine needle aspiration cytology as an aid to diagnosis, categorization and treatment when pure neuritic leprosy presents as nerve abscess

Kiran

Menon

2013

J Cytol

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Background:Pure neuritic leprosy (PNL) usually presents with neurological symptoms without skin involvement. Fine needle aspiration can play an important role in the management of PNL cases presenting as nerve abscesses.Aim:To assess the role of fine needle aspiration cytology (FNAC) in diagnosing and categorizing PNL cases presenting as nerve abscesses in the absence of neurological symptoms.Materials and Methods:Five patients with subcutaneous nerve related swellings without clinically evident neurological deficits were subjected to FNAC. As the cytological features were suggestive of nerve abscesses due to leprosy, Fite stain was performed in all cases. As none of the patients had any leprosy skin lesions, they were diagnosed as cases of PNL. Features like cellularity, caseous necrosis, presence or absence of lymphocytes, macrophages, epithelioid cells, granulomas, Langhans giant cells and nerve elements were analyzed with the bacteriological index, to categorize PNL according to the Ridley-Jopling classification.Results:Based on the cytological features and bacteriological indices, 3 cases were cytologically categorized into tuberculoid (TT)/borderline tuberculoid (BT) leprosy and the other two, as BT/borderline lepromatous (BL) and BL leprosy respectively in spite of having similar clinical presentation. Based on the cytological diagnoses, category-specific treatment could be instituted with clinical improvement.Conclusions:The simple and minimally invasive FNAC procedure allows diagnosis and a reasonably accurate categorization of PNL presenting as nerve abscess and therefore, highly useful in its clinical management.

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Use of Fine Needle Aspiration Cytology in Leprotic Lesions

Cited by 11 publications

References 3 publications

Modified fine‐needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

Modified fine‐needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

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

Fine needle aspiration cytology as an aid to diagnosis, categorization and treatment when pure neuritic leprosy presents as nerve abscess

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