A plea for routine use of fine-needle aspiration cytology in the diagnosis and follow up of leprosy
To the Editor:
We have previously described diagnostic line-needle aspiration cytology in nodular lepromatous leprosy (1) and subsequently in leprosy lesions through the Ridley-Jopling (R-J) spectrum (2). The techniques we used to obtain material for cytological study were: a) fine-needle aspiration cytology using a 10-ml syringe attached to a 23-gauge needle and b) cytopuncture, performed without negative pressure (2). These procedures were performed by a pathologist.
Cytologic evaluation of leprosy patients is being tried on a larger scale in our institution. The procedures are now being performed by dermatologists at the time of initial examination of the patient. The simplicity and rapidity of the technique, the abundance of cytologic material obtained, the amount of information generated enabling classification in the R-J scale by reading May-Grunwald-Giemsa in conjunction with Ziehl-Neelsen-stained smears has enthused our clinical colleagues. In addition, the absence of trauma and scarring are appreciated by the patient, and reports can be issued in a few hours.
Cytology is an established tool in the diagnostic workup of a large number of in flammatory and neoplastic conditions. Most pathologists are familiar with the techniques and are comfortable with reading cytology smears. We propose that cytology be advocated as a routine tool in the evaluation of leprosy patients because it can even be implemented in the field setting. We feel that as experience with the cytology of leprosy accumulates the accuracy of reporting improves to a level comparable to histopathology in most cases.
- Navjeevan Singh, M.D.
Reader
Department of Pathology
- Vinod K. Arora, M.D.
Reader
Department of Pathology
- Arati Bhatia, M.D.
Professor
Cytology Section
Department of Pathology
- S. N. Bhattacharya
Lecturer
Department of Dermatology
University College of Medical Sciences & GTB Hospital
Delhi 110 095, INDIA
REFERENCES
1. SINGH, N., ARORA, V. K. and RAMAM, M. Nodular lepromatous leprosy: report of a case diagnosed by FNA. Diagn. Cytopathol. 11(1994)373-375.
2. SINGH, N., BHATIA, A., GUPTA, K. and RAMAM, M.The cytomorphology of leprosy across the Ridley-Jopling spectrum. Acta Cytolog. (1995) in press.
Reprint requests to Dr. Bhatia.