Lepromatous Lymphadenitis: A Rare Manifestation of LeprosyDiagnosed by Fine Needle Aspiration Cytology

Introduction

Leprosy is a widespread infectious and contagious disease with a preva-lence rate of 0.4 per 10,000 population in India. It is a chronic infectious disease causedby Mycobacterium leprae and mainly affects the skin, the peripheral nerves, the mucosaof the upper respiratory tract, and the eyes. Lymph node involvement is rare.

Case Description

A 24-year-old male presented with right lower limb numbnessfor one year and a non-healing knee ulcer for one month, along with recurrent ulcers,sensory loss, and erythematous macules. Nerve conduction studies showed that thebilateral ulnar and sural nerves were non-excitable, and the median nerves had reducedamplitude. FNAC of a right inguinal lymph node revealed foamy macrophages andill-defined granulomas; Modified Ziehl-Neelsen stain demonstrated numerous acid-fastbacilli, indicating lepromatous lymphadenitis. A punch biopsy from the knee ulcershowed epithelioid granulomas, foamy macrophages, and a Grenz zone with positiveAFB staining. A diagnosis of Borderline Lepromatous (BL) leprosy was confirmed.The patient was started on multidrug therapy and showed clinical improvement.

Conclusion

When Leprosy presents as lymphadenopathy, FNAC can be a very usefultool for the diagnosis of Lymphadenopathy due to Leprosy and excludes other possi-bilities of Lymphadenitis. It is also a simpler, quicker, and less invasive technique fordiagnosing such rare lesions