Correlation of histopathologic changes in the liver and bone marrow of leprosy patients.

Lepromatous leprosy is a sys temic disorder. In many cases there is extensive involvemen,t not only of the reticuloendothelial system, but also of other organs. Intimal cells of blood vessels may be almost bursting with leprosy bacilli. Liver changes in lepromatous leprosy are well known. They consist chiefl y of foam-cell granulomas, with or without acid-fas t bacilli, in the portal ti ssues and elsewhere in the liver lobule and in accumulations of acid-fas t bacilli in the Kupffer cells and sinusoidal Jining cells. Comparatively little information, however, exists about histopathologic changes of internal organs in indeterminate, dimorphous ( borderline), and tuberculoid leprosy particularly during the life time of the patient. Recently it has been shown that acid-fast bacilli may be present in the liver, and that tuberculoid granulomas can exist in this organ in the case of tuberculoid and indeterminate leprosy ( 11 . IG . 19) . Shivde and Junnarkar (1 8), however, did not find granulomas in nine liver biopsies from cases of tuberculoid leprosy. Acid-fast bacilli were found by Bru and Rollier (2), while Camain et al. (3) did not find acid-fas t bacilli in 13 of 41 liver biopsies with epithelioid granulomas. Job et al. ( 11 ) detected no acid-fast bacilli in liver biopsies of tuberculoid cases, but in granulomas of borderline cases they saw numerous bacilli with the Comory methenamine silver stain, but not with the Fite stain. Little and sometimes contradictory information exists about liver lesions in indeterminate leprosy.