人癩の病理組織学的研究(第4報)

Abstract

Histochemical studies were conducted on the fat content of lesions in the skin, nerves and lymphnodes of lepromatous leprosy, giant vacuoles in the lymphnodes of neural leprosy, lipoid pneumonia due to suppurative inflammation, xanthoma and the myelin sheath of peripheral nerves. The following results were obtained.1) The fat in lepra cells is chiefly phospholipid (lecithin) and fatty acid and this coin-cides with the fat contained in leprosy bacilli. Foam cells contain a small amount of neutral fat (glycerol) besides the above acidic fats and at times sterol is found, but this can be interpreted as a process of cell degeneration. These findings are present in the lesions in the skin, nerves and lymphnodes and though the lesions in the skin and nerves are absorbed and disappear, the fat deposition in the lymphnodes remains.2) The fat in old lesions in the lymphnodes (obtained at autopsy) is composed of a considerable quantity of glycerol and cholesterol (ester form) besides a large amount of phospholipid (lecithin) and fatty acid. At times cholesterol is not found.3) Chaulmoogra oil reacts to Nile red and shows a phytosterin reaction. This coincides quite well with the properties of glycerol and cholesterol which were presented as charac-teristic of fats of old lymphnodes.4) The fat deposition in the lymphnodes of lepromatous leprosy observed at autopsy is composed not only of the so-called lipoid substances included in the lepra cells and foam cells but also of chaulmoogra oil which has been administered therapeutically. This is especially marked in the lymphnodes of the extremities. The leprous lymphatic reticulosis arising from invasion by leprosy bacilli appears to aid deposition of fat transported from the periphery.5) The giant vecuoles observed in the lymphnodes of neural leprosy can only be interp-reted as arising from saponification of chaulmoogra oil.6) The pathological fat in xanthoma and suppurative lipoid pneumonia is composed of a large quantity of phospholipid (lecithin), cholesterol (ester from) and fatty acid, and also a small amount of glycerol. Glycolipid is found besides the above in myelin sheath of the peripheral nerves and the phospholipid is made up of lecithin and sphingomyelin.