Cytological Diagnosis In A Case Of Histoid Leprosy
Sanjay Singh Chufal,
Sri Sai Kripa, Lohariyasal Talla,
P.O- Kathgharia, Haldwani,
Dist- Nainital, Uttarakhand, India.
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Histoid leprosy, a variant of lepromatous Leprosy, usually develops due to resistance to dapsone monotherapy. It also can arise denovo. The clinical presentation of Histoid leprosy can mimic other inflammatory and some neoplastic conditions, especially if it arises denovo. FNA cytology can be performed as an outdoor procedure and can provide a quick and reliable diagnosis in such cases. A 35 year old male presented with multiple nodules all over the body. There was no previous history of Leprosy or antileprotic treatment. The clinical differential diagnoses were Post Kala azar dermal Lehishmaniasis (PKDL), Histoid Hansenâ€™s leprosy and Cutaneous metastasis. FNA with a 23G needle showed numerous histiocytes which were filled with intracellular and extracellular negative bacillary images. These bacilli were arranged parallel to each other rather than in a random manner, which differentiated it from Atypical mycobacterial cutaneous infection, although a rare condition, without the aid of special stains and other ancillary investigations. Ziehl Neelsenâ€™s staining for acid fast bacilli was positive. The arrangement of the negative bacillary images was important in distinguishing it from Atypical Mycobacterial infection, as FNA smears can be similar in both the cases and the treatment for both the entities is different. Subsequent histopathology confirmed the diagnosis and the patient responded to the treatment.