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[Pathological findings of the liver in Hansen's disease]
K Matsumoto1, M Yajima, G Asano
1Division of Pathology, Second Hospital of Nippon Medical School, Kanagawa, Japan.
Abstract:
In leprosy patients, granulomatous lesion are often observed, not only in skin and nerve, but also other visceral organs such as liver, kidney, spleen and cardiovascular system. But for the development of drug therapy, there are very few cases we can see the acid-fast bacilli in the lesion these days. We have reviewed the histopathological lesions in the liver of leprosy patients who had been treated for long term, based on autopsy findings of 31 cases, including 24 cases with lepromatous leprosy (LL) and 7 cases with tuberculoid leprosy (TL). Except one case of LL with progressive stage, most of them diagnosed as retrogressive or quiescent stage. Morphologically, acid-fast bacilli and granuloma were seen in a few cases of Hansen's disease. In addition, no suggestive changes of drug and virus induced liver injury were recognized. However, sclerotic change of portal vein was remarkably encountered in the tuberculoid leprosy.
Insights
Leprosy can affect visceral organs like the liver, even in treated patients. Autopsy findings revealed few acid-fast bacilli but noted portal vein sclerosis in tuberculoid leprosy cases.
Area of Science:
- Hepatology
- Infectious Diseases
- Pathology
Context:
- Leprosy, a chronic infectious disease, commonly causes granulomatous lesions in skin and nerves.
- Visceral organ involvement, including the liver, is recognized in leprosy patients.
- Detecting acid-fast bacilli in lesions has become less common with long-term drug therapy.
Purpose:
- To investigate histopathological liver lesions in leprosy patients with long-term treatment.
- To correlate autopsy findings with leprosy types (lepromatous and tuberculoid) and disease stage.
- To identify any drug or virus-induced liver injury and specific vascular changes.
Summary:
- Autopsy of 31 leprosy patients (24 lepromatous leprosy, 7 tuberculoid leprosy) revealed mostly quiescent or retrogressive stages.
- Acid-fast bacilli and granulomas were infrequently observed in the liver lesions.
- No evidence of drug or virus-induced liver injury was found; however, portal vein sclerosis was common in tuberculoid leprosy.
Impact:
- This study provides insights into the long-term histopathological liver changes in treated leprosy patients.
- Findings suggest that portal vein sclerosis is a notable feature in tuberculoid leprosy.
- The study contributes to understanding the visceral manifestations of leprosy and potential treatment-related changes.