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British Medical Bulletin 44:584-599 (1988)
© 1988 The British Council

research-article

Histopathology of leprosy and tuberculosis—an overview

S B Lucas

Wolfson Tropical Pathology Unit, London School of Hygiene & Tropical Medicine London

Abstract

The histopathological inflammatory reactions to Mycobacterium leprae can be organised along an immunopathological spectrum. The aspects of lymphocytic infiltrate, T-cell subset types, macrophage activation, and control of bacillary multiplication are generally consistent throughout the body, and they correlate well with clinical appearances and prognosis. With tuberculosis a comparable spectrum is less apparent Local anatomical factors and contemporary intensity of bacillaemia are as important in determining pathology as systemic host immune factors; the histological type of granulomatous reaction is less predictive in most cases. Unusual patterns of reaction to M. tuberculosis and M. leprae show that the cellular mechanisms involve more complex factors than we yet understand.


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