麻风病的临床组织病理学相关性

Clinico histopathological correlation in leprosy.

作者信息

Shivaswamy K N, Shyamprasad A L, Sumathy T K, Ranganathan C, Agarwal Vidushi

机构信息

M S Ramaiah Medical Teaching Hospital Bangalore, Karnataka, India.

出版信息

Dermatol Online J. 2012 Sep 15;18(9):2.

PMID:23031369

Abstract

INTRODUCTION

Leprosy is a chronic infectious disease caused by M. leprae, which presents in different clinico-pathological forms, depending upon the immune status of the host. Clinical classification gives recognition only to gross appearances of the lesions, whereas the parameters used for the histopathological classification are well defined, precise, and also take into account the immunological features.

RESULTS

Of the 182 suspected cases of leprosy which were biopsied, the clinical diagnosis was TT in 32 (17.5%), BT in 70 (38.4%), BB in 5(2.7%), BL in 24 (13.1%), LL in 23 (12.6%), and indeterminate in 28 (15.3%) cases. Of the 182 cases, which were biopsied, only 136 (74.7%) showed histological features consistent with any one type of leprosy. The overall clinicohistological correlation was 74.7 percent. A comparison of the histopathological pattern with that of clinical pattern revealed that the maximum correlation was seen with LL (84.2%), followed by BL (73.3%), BT (64.1%), TT (56%), BB, and IL (50%).

CONCLUSION

Because there is some degree of overlap in different types of leprosy, especially the unstable forms, the correlation can be made more accurate by combining clinical and histopathological features.

摘要

引言

麻风是由麻风杆菌引起的一种慢性传染病，根据宿主的免疫状态呈现出不同的临床病理形式。临床分类仅依据病变的大体外观，而组织病理学分类所使用的参数定义明确、精确，并且还考虑了免疫学特征。

结果

在182例接受活检的疑似麻风病例中，临床诊断为结核样型（TT）32例（17.5%），界线类偏结核样型（BT）70例（38.4%），中间界线类（BB）5例（2.7%），界线类偏瘤型（BL）24例（13.1%），瘤型（LL）23例（12.6%），未定类28例（15.3%）。在这182例接受活检的病例中，只有136例（74.7%）表现出与任何一种麻风类型相符的组织学特征。总体临床组织学相关性为74.7%。组织病理学模式与临床模式的比较显示，瘤型（LL）的相关性最高（84.2%），其次是界线类偏瘤型（BL，73.3%）、界线类偏结核样型（BT，64.1%）、结核样型（TT，56%）、中间界线类（BB）和未定类（IL，50%）。