Fibrous histiocytoid leprosy of the cornea

We describe a 50-year-old man with a 10-year history of gradually enlarging limbal tumors and conjunctival injection. An excised limbal mass presented a diagnostic challenge histopathologically and was initially believed to be a fibrous histiocytoma. Special stains, however, revealed acid-fast organisms in the fibrous histiocytes, and the diagnosis was changed to corneal leproma. This case confirms the existence of fibrous histiocytoma-like lesions in leprosy, which in this form can be termed fibrous histiocytoid leprosy. Furthermore, it suggests the need for special stains to rule out infectious cause in lesions believed to be atypical fibrous histiocytomas.