The histological aspects of leprous neuritis

ABSTRACT

This study of leprotic neuritis deals with such lesions in (a) nodular leprosy, (b) pure nerve leprosy, (c) tuberculoid leprosy, and (d) terminal nerve branches in relation to leprotic skin lesions of various kinds. In the neuritis of nodular leprosy the infiltration consists essentially of Virchow´s vacuolized cells full of Hansen bacilli, insinuated between the nerve fibers, which are compressed and secondarily destroyed. In the neuritis of pure nerve leprosy there appear between the nerve fibers small infiltrative foci consisting essentially of lymphocytes. Intense fibrosis follows, and in this tissue calcareous salts may be deposited. Bacilli are as a rule very scanty. In tuberculoid neuritis the infiltration located between the nerve fibers is composed essentially of epithelioid cells, giant cells and lymphocytes; caseation and calcification may also accur. Bacilli are pratically not demonstrable. When the nerve branches ending in skin lesions of leprosy are affected, as they very frequently are, they show primarily slight leprotic infiltrations around the perineurium. In a more advanced stage the latter is destroyed, the nerve appearing to be invaded by the infiltration, which compresses the nerve fibers until they are completely destroyed.