Correlações histopatológicas entre pele e linfonodos nas fases evolutivas da hanseníase Virchoviana

Abstract

An analysis of evolutive correlation in skin and lymphonodes of 30 patients with lepromatous leprosy was performed. Ten were active lepromatous in progression, 10 active lepromatous in regression and 10 residual lepromatous (inactive). The analysis of the skin and lymphonodes biopsies in the two former groups showed a remarkable heterogeneity in the constitution of specific granuloma in lymphonodes contrasting with the homogeneous constitution of cutaneous granuloma. In the third group whose material was taken from necropsies, the residual infiltrate in skin were discret, meanwhile the lymphonodes maintained, in the majority of cases, extensive paracortical, residual, macrophagic granulomas. The macrophagic granuloma in lymphonodes ordinarily showed a characteristic stratification with a tendency of younger macrophages and solid bacilli to locate in cortical and paracortical areas, whereas macrophages with regressive characteristics containing granular bacilli were situated in deep paracortical areas. There was an intense depletion of paracortical lymphocitic population, follicular hyperplasia and numerous plasma cells in the active lepromatous, whereas in residual lepromatous the follicular hyperplasia disappears, medular plasma cells are maintained and the paracortical lymph ocytic depletion remains. Three regressive and one residual lepromatous presented alterations peculiar to erythema nodosun leprosum in lymphon odes and peri vascular amyloid deposition were found in two inactive lepromatous.