Biomedical subjects
Publications and source records attributed to J C Gupta.
Microfilariae were observed in May-Grünwald-Giemsa-stained brushing smears of the laryngeal and pharyngeal areas in a 35-year-old man with carcinoma of the pharyngeal wall and marked laryngeal edema. Liberation of microfilariae due to lymphorrhexis following severe lymphedema was considered to be the mechanism for the infestation of these sites, which has not been previously reported.
Renal biopsies from 50 cases of leprosy, including 45 cases of lepromatous and 5 cases of tuberculoid, have been studied in detail histopathologically with special reference to any specific leprosy lesion such as the presence of leproma or granuloma, the presence of acid-fast bacilli and the occurrence of amyloid deposit. Leproma or granuloma, acid-fast bacilli and amyloid deposit could not be detected in any of these cases. Pathologic features of nephritis of various types were seen in only 40% of cases. Similar observations made by previous authors have been reviewed. The question is raised as to why kidney tissue should escape from developing specific leprosy lesions in either type of leprosy when other tissues such as liver, striated muscles and lymph nodes are known to develop such lesions. A greater immunologic resistance of the renal tissue to lepra bacilli or local physiochemical factors which may render renal tissue an unfavorable site for the settling and multiplication of lepra bacilli are considered as possible related factors.
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Histopathologic changes in striated muscle biopsies in 50 cases of leprosy were studied; 40 being the lepromatous type and 10 the nonlepromatous type. All the biopsies were obtained from midportions of normal looking biceps muscles and paraffin embedded. Sections cut in transverse and longitudinal planes were stained by hematoxylin and eosin, Masson's trichrome, Mallory's PTAH, Gomori's silver impregnation, and Ziehl-Neelsen's technic. Lepromas, focal or confluent, in the endomysium, perimysium, muscle fibers and perineurally, constituted the most common pathological lesion, being observed in 34% of all cases with a higher frequency in the lepromatous type. Acid-fast bacilli could be demonstrated in some of these lepromas. These nodules were observed even in younger patients and increased in frequency as the age of patient advanced. Three cases of nonlepromatous leprosy showed granulomas. Other changes noted in varying proportions were loss of striations, hyaline change, fatty change, sarcolemmal changes, along with endomysial thickening, muscle necrosis and fibrosis. Bacillemia in leprosy and the possible route of muscle invasion resulting in subsequent production of leprous nodules with associated degenerative changes, indpendent of nerve involvement, have been postulated.