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| Id: | 15309
| | Author: | Wade, H. W. | | Title: | Tuberculoid changes in leprosy. III. The pathology of a nerve abscess.
| | Source: | Int. J. Lepr;2(3):293-300, Aug.-Oct. 1934. ilus.
| | Abstract: | A description is given of the histopathology of a specimen of the peculiar chronic leprous nerve abscess of India, the frequency of wich in that country - if not its occurrence at all - constitutes one of the regional peculiarities of the disease. The tissue is a highly organized tuberculoid granuloma, with outer capsular and inner pseudo-villous layers. The latter consists of isolated, vascular lymphoid follicles clothed top and sides with a layer of proliferating tuberculoid tissue; necrosis of this occuring beyond a given distance produces villosities in a strikingly regular manner. The cpsule is of comparatively finely-knit structure, well supplied with vessels; it apparently derived from the perineurium, indicating that the process arose within a nerve cord. This finding, in view of the evident frequence of tuberculoid affection of the nerve in India, and on the other hand the non occurrence in the Philippines of abscess of this kind and the rarity and unimportance there of tuberculoid lesions of the nerve, indicates that the latter forms the basis of the former. In view of the clinical features, and especially of Lowe´s opinion that this absces formation is a reaction condition and greatly increased in frequency by the use of potassium iodite, it is accepted as entirely probable that the condition is a manifestation of lepra reaction and, more specifically, of chronic, persistent lepra reaction in a tuberculoid lesion. The extensive epithelioid production is in keeping with findings in chronic reaction of tuberculoid skin lesions and is a further indication that that feature is characteristic of chronic reaction in lesions of that nature. Leprosy bacilli were not found in this specimen, though Lowe found a few, apparently degenerated, in about half of his cases. However, though there is need of further control work, the causative agent is in all probability that of leprosy. It is believed that these abscesses are worthy of further attention. It remains to be determined whether they are regularly tuberculoid and regularly associated with reaction. The fact that they are apparently limited to males involves an intriguing question. Finally, material from these lesions might prove of special value in an investigation of the hypothetical submicroscopic form or phase of the leprosy bacillus. (AU).
| | Descriptors: | HANSENIASE TUBERCULOIDE/diag
HANSENOSTATICOS/ef adv
HANSENOSTATICOS/farmacol
HANSENOSTATICOS/uso terap
- GRANULOMA/patol
| | Limits: | HUMANO
| | Electronic Medium: | http://www.ilsl.br
| | Location: | BR191.1 |
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