PATHOLOGICAL STUDIES ON THE LIVER OF AUTOPSY MATERIAL IN LEPROSY (Part 2)

Abstract

The following results were obtained from the macro- and microscopical examinations on the liver of autopsy material of 20 leprous cases (lepromatous 19 and neural 1).
1) The degree of histological and bacteriological improvement of lepromata in the liver is proportionate to that of lepromata in the skin.
In the relapse after temporary improvement, the course of lepromata in the liver is in proportion to that of skin lesion, but the liver change is not always subordinate to the skin lesions. Sometimes, the local relapse of lesion takes place in the liver, which can be the sourse of aggravation of skin and general disease.
2) In some cases the progresses of development of change in the lobule differ from that in the interstitium.
3) There exist macroscopically yellowish and whitish lepromata. This difference of the color tone is originating in the quantity of lipid in lepra cells of the lepromata.
4) The distribution of hematogenously disseminated leprosy bacilli is not always equable, but various in each loubule or in part of the lobule itself.
5) Though many factors except leprosy can influence upon the liver cells, atrophy, necrosis and disappearance of liver cells may be attributed directly or indirectly to leprosy, for example the pressure of numerous lepromata in the lobule, or the local congestion due to stenosis or obliteration of the central veins caused by the leprous changes.
6) The fatty degeneration caused by leprosy takes the type of peripheral fatty degeneration.
7) Leprosy shows a stronger tendency than tuberculosis to affect the central veins.
8) The proliferation of the interstitium is generally in proportion to the degree of changes in liver, and is also influenced by the ratio occupied by the improving lepromata. And there seems to exisit the disparity in the intensity of connective tissue reaction between tie individuals.
9) The elastic fiber is weaker in resistense than the reticular and collagenic fibers, and easily broken and disappear and difficult to regenerate. Besides such remarkable breaking and disppearence, new growth of the elastic fibers, though in a slight degree, can be observed in some cases.
10) The vessels, regarding the tunica intima of the arteries, in the interstitium undergo leprous changes often, and sometimes the veins are invaded.
11) The individual differences of the intensity of connective tissue reaction participate in the thickning of the liver capsule as well as the proliferation of interstitium.