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Investigating the Phagocytosis of Leishmania using Confocal Microscopy
Published on: July 29, 2021
New cytologic clues in localized Leishmania lymphadenitis
Yahya Daneshbod1, Khosrow Daneshbod, Bijan Khademi
1Department of Cytopathology and Hematopathology, Dr. Daneshbod Pathology Laboratory, Shiraz School of Medicine, Shiraz, Iran. daneshbk@yahoo.com
Insights
New cytologic clues aid in diagnosing localized leishmania lymphadenitis (LLL), especially when Leishman-Donovan (LD) bodies are not readily detected. This research identifies key cellular findings for improved LLL diagnosis.
Area of Science:
- Medical Parasitology
- Cytopathology
- Infectious Diseases
Background:
- Localized leishmania lymphadenitis (LLL) diagnosis traditionally relies on detecting Leishman-Donovan (LD) bodies.
- Cytologic examination offers a minimally invasive approach to diagnosing LLL.
Purpose of the Study:
- To identify and describe novel cytologic indicators for the diagnosis of localized leishmania lymphadenitis (LLL).
- To enhance diagnostic capabilities for LLL, particularly in cases where LD bodies are scarce.
Main Methods:
- Analysis of cytologic smears from 170 LLL cases (120 confirmed by LD bodies, 50 by histology).
- Comparative study with smears from tuberculous, toxoplasma, and unspecified granulomatous lymphadenitis.
Main Results:
- Key suggestive cytologic findings include LD kinetoplasts, specific plasma cell inclusions, and lymphogranular bodies.
- Novel findings reported: intraneutrophilic LD bodies, hematoxylin body-like inclusions, fibroblasts, cytoplasmic blebbing, and floating parasitophorous vacuoles.
Conclusions:
- Cytologic clues can strongly suggest LLL even when LD bodies are not easily found.
- These findings expand the diagnostic criteria for LLL, aiding in the identification of this self-limited condition.
Objective:
To describe new cytologic clues to diagnose localized leishmania lymphadenitis (LLL).
Study Design:
The study examined cytologic smears of 170 cases of LLL referred to our department from November 1989 to October 2004. A total of 120 cases were confirmed by detecting Leishman-Donovan (LD) bodies in at least 1 of the cytologic smears and 50 cases, which were histologically confirmed. For comparison we studied cytologic smears of 20 cases of tuberculous lymphadenitis, 20 cases of toxoplasma lymphadenitis and 20 cases of granulomatous lymphadenitis of unspecified causes.
Results:
Cases were divided into 4 major groups. Cytologic findings in these groups were studied to find highly suggestive clues. Cytologic findings present in most of these groups, but absent or very rare in other granulomatous lymphadenitis, were LD kinetoplasts, plasma cells with different shapes of inclusions and lymphogranular bodies. Rare findings not reported previously were: intraneutrophilic LD bodies, hematoxylin body-like inclusions, fibroblasts, cytoplasmic blebbing and floating parasitophorous vacuoles.
Conclusion:
Despite previous reports emphasizing detecting LD bodies in diagnosing LLL, we present cytologic clues highly suggestive of this self-limited disease when LD bodies cannot be detected or are very few on the smears.
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