Regional lymph node involvement in tuberculoid leprosy

Area of Science:

• Immunology
• Pathology
• Dermatology

Background:

• Leprosy is a chronic infectious disease primarily affecting the skin and peripheral nerves.
• Tuberculoid leprosy represents one end of the leprosy spectrum, characterized by a strong cell-mediated immune response.
• Understanding lymph node involvement is crucial for assessing immune status and disease progression.

Purpose of the Study:

• To investigate the histopathological changes in regional lymph nodes of patients with tuberculoid leprosy (TT) and borderline tuberculoid (BT) leprosy.
• To correlate lymph node findings with the host's immune response and disease classification.

Main Methods:

• Histopathological examination of lymph node biopsies from 44 patients with confirmed tuberculoid leprosy (26 TT, 18 BT).
• Assessment for the presence of granulomas, paracortical lymphocytes, and acid-fast bacilli (AFB).
• Comparative histopathological analysis of skin lesions and lymph nodes.

Main Results:

• In polar tuberculoid (TT) leprosy, lymph nodes showed paracortical lymphocytes (76.92%), granulomas (61.52%), and AFB (11.54%).
• In borderline tuberculoid (BT) leprosy, lymph nodes revealed granulomas (61.1%), paracortical lymphocyte infiltration (72.22%), and AFB (11.11%).
• Tuberculoid leprosy lesions were confirmed in both skin and lymph nodes, with abundant paracortical lymphocytes suggesting high cell-mediated immunity.

Conclusions:

• Lymph node histopathology provides evidence of tuberculoid leprosy lesions and reflects the host's immune status.
• The presence of numerous paracortical lymphocytes in lymph nodes is indicative of a strong cell-mediated immune response, characteristic of the tuberculoid end of the leprosy spectrum.