Fine needle aspiration cytologic diagnosis of erythema nodosum leprosum: acase report
BACKGROUND: Erythema nodosum leprosum (ENL), the type 2 lepra reactionoccurring in lepromatous or borderline lepromatous leprosy, presents clinically with acutemanifestations that compel the patient to seek medical attention. Recognition and timely managementof these patients is critical in order to avoid permanent disability. Fine needle aspirationcytology (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 multipleraised, reddish, painful swellings of the bilateral forearms and legs for 7 days. One yearpreviously, she was diagnosed and treated for lepromatous leprosy with type 2 reaction. After athorough clinical examination a diagnosis of ENL was made. FNA smears from the forearm swellingsshowed pus-like material with intact and degenerated polymorphonuclear leukocytes and many foamymacrophages with strong granular acid-fast bacillus (AFB) positivity. A cytologic diagnosis of ENLwas given, which was confirmed on histopathologic examination of skin biopsy. CONCLUSION: Cytologicfeatures such as a large number of intact and degenerated neutrophils with foamy macrophages andstrong granular AFB positivity, in an appropriate clinical background, allows a confident diagnosisof ENL.
Siddaraju,N　Roy,SK　Bundele,MM　Badhe,BA　Thappa,DM
Department of Pathology, Jawaharlal Institute of Postgraduate MedicalEducation and Research, Pondicherry, India. rajusiddaraju@yahoo.com
Adult　 Biopsy, Fine-Needle　 Cytodiagnosis　 Erythema Nodosum　 Female Humans
