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Fine needle aspiration cytologic diagnosis of erythema nodosum leprosum: a case report.

Abstract

BACKGROUND: Erythema nodosum leprosum (ENL), the type 2 lepra reaction occurring in lepromatous or borderline lepromatous leprosy, presents clinically with acute manifestations that compel the patient to seek medical attention. Recognition and timely management of these patients is critical in order to avoid permanent disability. Fine needle aspiration cytology (FNAC) is a simple, effective tool that aids in correct diagnosis and management of ENL.

CASE: A 30-year-old woman presented with history of fever, reddening of the face, and multiple raised, reddish, painful swellings of the bilateral forearms and legs for 7 days. One year previously, she was diagnosed and treated for lepromatous leprosy with type 2 reaction. After a thorough clinical examination a diagnosis of ENL was made. FNA smears from the forearm swellings showed pus-like material with intact and degenerated polymorphonuclear leukocytes and many foamy macrophages with strong granular acid-fast bacillus (AFB) positivity. A cytologic diagnosis of ENL was given, which was confirmed on histopathologic examination of skin biopsy.

CONCLUSION: Cytologic features such as a large number of intact and degenerated neutrophils with foamy macrophages and strong granular AFB positivity, in an appropriate clinical background, allows a confident diagnosis of ENL.

More information

Type
Journal Article
Author
Siddaraju N
Roy SK
Bundele MM
Badhe BA
Thappa DM
Year of Publication
2007
Journal
Acta cytologica
Volume
51
Issue
5
Number of Pages
800-2
Date Published
2007 Sep-Oct
Language
eng
ISSN Number
0001-5547
DOI
10.1159/000325845
Alternate Journal
Acta Cytol.
Publication Language
eng

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