HISTOPATHOLOGICAL STUDIES ON HUMAN LEPROSY (The lst Report)

Findings of Lymphatic System

Abstract

The all lymph nodes and lymphoid tissues of the 15 dead leprosy patients were collected at autopsies and their 603 specimens were histologically investigated.
The tissue reactions were devided into 4 types. 1) the change occured chiefly in reticulum and contained migrating simple large cells (large cell type), 2) foamy cells stained with Sudan III and in serious cases diffuse fatty infiltration were observed (foamy type), 3) in which, accomapnied with fatty infiltration, giant vacuoles suggestive of fatty masses and giant cells of foreign bodies were recognized (fat accumulating type) and 4) which produced necrosis (necrosed type).
In macular and neural leprosy, findings observed were similar to those of simple lymphadenitis, while in tuberous leprosy fatty infiltration is interpreted as a chief histological change.
Fatty infiltration is consisted by the so-called foamy cells derived from the reticulum system. In the lesions with giant vacuoles and foreign body giant cells, fatty tissue debris from the skin or the peripheral nerves are carried through the lymph stream and caught by the lymphnodes of the filter activity, the reticuloendothelial system and the foreign body giant cells with strong phagocytic ability accumulate fatty substances.
Fatty infiltration is recognized most intense in the superficial lymph nodes, especially in the inguinal nodes, becomes weaker in the profound nodes and no sign of it in the visceral nodes. But the lymph nodes of the liver port and pylorus present fatty infiltration. In the case after erythema nodosum leprosum remarkable necrosis was observed in the liver port.
In macular and neural leprosy no appreciable change was observed in the lymphoid tissues. Foamy cells appeared in the lymph follicles of the spleen in tuberous leprosy, but other tissues presented no change.
The result of bacillus research by the fluorescence microscope was extremely low. In general, bacilli were recognized in a small number as brilliant granules in the cells with dull fluorescence (a kind of foamy cells).