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Related Experiment Videos

"Pseudoneoplastic" leprosy. Leprosy revisited

J A Triscott1, O Nappi, G Ferrara

  • 1Section of Dermatopathology, Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, Missouri, USA.

The American Journal of Dermatopathology
|June 1, 1995
PubMed
Summary
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A rare case of histoid leprosy mimicking a skin neoplasm in an Italian man is presented. Early diagnosis of leprosy is crucial to avoid misdiagnosis of cancer.

Area of Science:

  • Dermatopathology
  • Infectious Diseases
  • Oncology

Background:

  • A 70-year-old Italian man with a history of lung squamous cell carcinoma presented with a nodular skin eruption after extensive travel in India and Sri Lanka.
  • The skin lesions were well-demarcated nodules up to 3.5 cm in diameter.

Observation:

  • Histological examination revealed a proliferation of spindled and polygonal cells with vacuolation, suggesting a macrophage-monocyte lineage via immunohistochemistry.
  • Initial assessment suggested a possible "histiocytic" neoplasm due to infiltrating borders and subcutaneous extension.
  • Fine-needle aspirate revealed intracellular bacilli on acid-fast stains, and a subsequent excision showed typical lepromatous leprosy morphology.

Findings:

  • The patient's clinicopathologic features were consistent with "histoid" leprosy, an unusual morphologic variant.

Related Experiment Videos

  • Intracellular bacilli were identified within vacuolated lesional cells, confirming leprosy.

    • Implications:

    • Unusual morphologic variants of leprosy can mimic neoplastic processes.
    • Consideration of leprosy is essential in diagnosing "histiocytic" infiltrates, irrespective of geographic location, to prevent misdiagnosis of neoplasia.