01909nas a2200337 4500000000100000008004100001260001300042653001200055653001000067653002400077653001000101653002800111653001100139653001200150653000900162653001300171653002600184653001600210100001600226700001400242700001200256700001400268700001500282700001100297700001200308245015000320300001000470490000700480520107000487022001401557 2009 d c2009 May10aAbscess10aAdult10aBiopsy, Fine-Needle10aCysts10aDiagnosis, Differential10aHumans10aleprosy10aMale10aNeuritis10aSoft Tissue Neoplasms10aUlnar nerve1 aSiddaraju N1 aSistla SC1 aSingh N1 aMuniraj F1 aChahwala Q1 aBasu D1 aKumar S00aPure neuritic leprosy with nerve abscess presenting as a cystic, soft tissue mass: report of a case diagnosed by fine needle aspiration cytology. a355-80 v373 a
Pure neuritic leprosy (PNL) with nerve abscess manifesting as a huge, cystic, soft tissue mass is highly uncommon. Fine needle aspiration cytology can serve as an important initial diagnostic modality in such an instance. We report a case of 28-year-old male, who presented with a huge swelling in the lower, medial aspect of the right upper arm. The clinical diagnosis was schwannoma. Fine needle aspiration (FNA) yielded 80 ml of sticky, turbid, pale brown fluid. Cytologic examination revealed abundant, caseous, necrotic material and many degenerated neutrophils in a thin proteinaceous background. Stain for acid fast bacilli (AFB) was negative. Based on an AFB negative, caseous, necrotic material obtained from the soft tissue mass located in the ulnar nerve region, a cytodiagnosis of tuberculoid PNL with nerve abscess was given, and this was confirmed by the subsequent histopathologic examination. Our case emphasizes the major role of minimally traumatic, FNA technique in the diagnosis of rare cases of clinically unsuspected neuritic leprosies.
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