Jha R, Karki S
Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2010 Apr;8(1):40-3.
Skin biopsies play an important role in diagnosing and classifying different types of leprosy. The aim of this study was to analyse different histologic types of leprosy, to correlate histopathological diagnosis with clinical diagnosis, to study the uniformity of clinical and histological findings in the diagnosis of leprosy and to evaluate difficulties faced during clinicopathological correlation according to Ridley- Jopling classification due to inadequacy of data provided.
This is a retrospective study of all skin biopsies reported from Department of Pathology of Tribhuvan University Teaching Hospital from 14 April 2007 to 13 April 2009, for which leprosy was the diagnosis or was strongly suspected on histopathology.
Out of 40 cases included, 33 were males and seven were females. Tuberculoid leprosy was the most common type comprising 23 /40 cases (57.5%). In 18/ 40 cases (45%), clinical diagnosis was leprosy. Only in three, leprosy was classified according to Ridley-Jopling criteria clinically. Thus clinicopathological correlation according to Ridley-Jopling criteria could not be done. Histopathological reporting lacked uniformity too. In 13/40 reports (32.5%), exact location of granuloma, presence or absence of Grenz zone and enroachment of epidermis by granuloma was not mentioned. None mentioned the number and distribution of lymphocytes or relative proportion of epithelioid cells and foamy histiocytes. Results: Out of 40 cases included, 33 were males and seven were females. Tuberculoid leprosy was the most common type comprising 23 /40 cases (57.5%). In 18/ 40 cases (45%), clinical diagnosis was leprosy. Only in three, leprosy was classified according to Ridley-Jopling criteria clinically. Thus clinicopathological correlation according to Ridley-Jopling criteria could not be done. Histopathological reporting lacked uniformity too. In 13/40 reports (32.5%), exact location of granuloma, presence or absence of Grenz zone and enroachment of epidermis by granuloma was not mentioned. None mentioned the number and distribution of lymphocytes or relative proportion of epithelioid cells and foamy histiocytes.
Histopathological diagnosis of leprosy did not correlated with clinical diagnosis significantly. Uniformity was not seen in the clinical or histopathological informations provided making it difficult to conduct retrospective clinico pathological correlation.
皮肤活检在不同类型麻风病的诊断和分类中起着重要作用。本研究的目的是分析麻风病的不同组织学类型，将组织病理学诊断与临床诊断相关联，研究麻风病诊断中临床和组织学发现的一致性，并根据里德利 - 乔普林分类法评估由于所提供数据不足在临床病理关联过程中面临的困难。
这是一项对特里布万大学教学医院病理科2007年4月14日至2009年4月13日报告的所有皮肤活检进行的回顾性研究，这些活检在组织病理学上被诊断为麻风病或高度怀疑为麻风病。
纳入的40例病例中，男性33例，女性7例。结核样型麻风是最常见的类型，占23/40例（57.5%）。18/40例（45%）临床诊断为麻风病。仅3例临床上根据里德利 - 乔普林标准对麻风病进行了分类。因此，无法按照里德利 - 乔普林标准进行临床病理关联。组织病理学报告也缺乏一致性。在13/40份报告（32.5%）中，未提及肉芽肿的确切位置、无颗粒层的有无以及肉芽肿对表皮的侵犯情况。没有一份报告提及淋巴细胞的数量和分布或上皮样细胞与泡沫状组织细胞的相对比例。纳入的40例病例中，男性33例，女性7例。结核样型麻风是最常见的类型，占23/40例（57.5%）。18/40例（45%）临床诊断为麻风病。仅3例临床上根据里德利 - 乔普林标准对麻风病进行了分类。因此，无法按照里德利 - 乔普林标准进行临床病理关联。组织病理学报告也缺乏一致性。在13/40份报告（32.5%）中，未提及肉芽肿的确切位置、无颗粒层的有无以及肉芽肿对表皮的侵犯情况。没有一份报告提及淋巴细胞的数量和分布或上皮样细胞与泡沫状组织细胞的相对比例。
麻风病的组织病理学诊断与临床诊断无显著相关性。所提供的临床或组织病理学信息缺乏一致性，使得进行回顾性临床病理关联变得困难。
