Role of Ultrasound-Guided Trucut Nerve Biopsy in the Diagnosis of Pure Neuritic Leprosy: The Way Forward

Case Presentation Background and Objective: The invasive open nerve biopsy, a prerequisite for diagnosis of pure neuritic leprosy(PNL), carries a risk for further compromising the nerve function. The objective of this study was to assess the role of ultrasound-guided trucut (core needle) biopsy of peripheral nerves in clinically suspected cases of PNL.

Methods: In this case series, six cases of PNL were subjected to ultrasound-guided trucut nerve biopsy during December 2020 to December 2022 period. One specimen was sent in formalin for histopathological examination and the other in ethanol for PCR of M. leprae.

Results: Epithelioid cells, epithelioid cell granuloma and foamy macrophages were found in the histopathology sections with the presence of acid-fast bacilli (M. leprae) in two cases. PCR was positive from the nerve tissue in all cases.

Conclusion: Trucut nerve biopsy may serve as an alternative to open nerve biopsies with the advantages of being minimally invasive, few patient complications and higher patient acceptance.