Gupta J C, Jesupadam T, Gupta M C, Gupta D K
Int J Lepr Other Mycobact Dis. 1975 Oct-Dec;43(4):348-55.
Histopathologic changes in striated muscle biopsies in 50 cases of leprosy were studied; 40 being the lepromatous type and 10 the nonlepromatous type. All the biopsies were obtained from midportions of normal looking biceps muscles and paraffin embedded. Sections cut in transverse and longitudinal planes were stained by hematoxylin and eosin, Masson's trichrome, Mallory's PTAH, Gomori's silver impregnation, and Ziehl-Neelsen's technic. Lepromas, focal or confluent, in the endomysium, perimysium, muscle fibers and perineurally, constituted the most common pathological lesion, being observed in 34% of all cases with a higher frequency in the lepromatous type. Acid-fast bacilli could be demonstrated in some of these lepromas. These nodules were observed even in younger patients and increased in frequency as the age of patient advanced. Three cases of nonlepromatous leprosy showed granulomas. Other changes noted in varying proportions were loss of striations, hyaline change, fatty change, sarcolemmal changes, along with endomysial thickening, muscle necrosis and fibrosis. Bacillemia in leprosy and the possible route of muscle invasion resulting in subsequent production of leprous nodules with associated degenerative changes, indpendent of nerve involvement, have been postulated.
对50例麻风患者的横纹肌活检组织病理变化进行了研究；其中瘤型麻风40例，非瘤型麻风10例。所有活检标本均取自外观正常的肱二头肌中部，并进行石蜡包埋。将横切面和纵切面切片用苏木精-伊红染色、Masson三色染色、Mallory磷钨酸苏木精染色、Gomori银浸染法以及齐-尼氏技术染色。在肌内膜、肌束膜、肌纤维和神经周围出现的局灶性或融合性麻风瘤是最常见的病理病变，在所有病例中占34%，在瘤型麻风患者中出现频率更高。在其中一些麻风瘤中可发现抗酸杆菌。这些结节在较年轻患者中也有发现，且随着患者年龄增长其出现频率增加。3例非瘤型麻风患者出现肉芽肿。还观察到不同比例的其他变化，包括横纹消失、玻璃样变、脂肪变、肌膜改变，以及肌内膜增厚、肌肉坏死和纤维化。有人推测麻风患者存在菌血症，以及肌肉受侵的可能途径，进而导致随后出现麻风结节及相关退行性改变，且与神经受累无关。
