Electron microscopic study of previously irradiated scleroma

Area of Science:

• Electron microscopy
• Pathology
• Microbiology

Background:

• Rhinoscleroma is a chronic granulomatous disease affecting the upper respiratory tract.
• Previous X-ray therapy is a treatment modality used in some cases.
• Mikulicz cells are characteristic histiocytes found in rhinoscleroma.

Observation:

• Nasal biopsies from two scleroma patients previously treated with X-ray therapy were examined.
• Electron microscopy was utilized to investigate the ultrastructure of the lamina propria.
• Attention was focused on the morphology of Mikulicz cells and surrounding tissues.

Findings:

• The majority of Mikulicz cells exhibited numerous small vacuoles.
• These vacuoles contained fine granular and fibrillar material of unknown origin.
• Electron-dense bodies resembling Russell bodies were observed near Mikulicz cells.
• Obstructed lymphatic vessels were occasionally noted, suggesting potential spread of Klebsiella rhinoscleromatis.

Implications:

• X-ray therapy may induce temporary suppression of inflammation, followed by granuloma reformation.
• The observed vacuoles and Russell bodies offer insights into Mikulicz cell function and pathology.
• The findings suggest a possible, albeit rare, route for Klebsiella rhinoscleromatis dissemination to lymph nodes.