[Histopathological study of the cubital epineurium in patients with undifferentiated forms of Hansen's disease].

Abstract

Twelve hanseniasis patients, undifferentiated group, with negative bacilloscopy and having undergone no prior treatment, were submitted to a biopsy of the cubial epineurium for histopathological study. All subjects were clinically observed after one month, and six of them were examined 4 to 5 years afterwards. Histopathology of the epineurium presented acid-fast bacilli in one patient and tuberculoid granuloma formation tendency in another. Epineural thickening was observed in nine patients and perivascular lymphomonocuclear inflammatory infiltration in six. The clinical examination after 1 month in the 12 patients as well as after 4 to 5 years in 6 of them, demonstrated innocuousness of the performed biopsy. Four to five years after the initial observation, the clinical examination showed that two patients who remained Mitsuda negative did not present histopathologically thickened epineurium at the beginning, while in four patients who then presented positive Mitsuda, the initial histopathological examination showed epineural thickening. Among the nine patients having a histopathologically thickened epineurium, six did not present initial lesions in the upper limbs. Therefore, the study of the cubital epineurium early thickening deserves special mention, and should be performed in a larger number of patients, as well as in control groups, since the follow-up of four among six patients showed epineural thickening and reversal of the Mitsuda reactions to positivity.