癩におけるガッセル氏神経節の病理組織学的研究

Abstract

Histopathologic studies of the semilunar (Gasserian) ganglia were conducted in a series of 25 cases of leprosy, 5 with the tuberculoid type and 20 with the lepromatous stype. The tissue specimens examined were bilateral in every case and particularly detailed microscopic examinations made in 14 of the cases, with the results leading to the following conclusions.1. Proliferation of the interstitial connective tissue was evident in the ganglia with focal round cell infiltration, in both the tuberculoid and lepromatous types.2. In patients with lepromatous type the nerve cells were noted to show vacuolar degenera-tion as well as atrophy or enlargement, with deformity, necrosis or loss of nuclei. Such alterations of nerve cells were scarcely demonstrable in the tuberculoid type.3. Leprosy bacilli were consistently demonstrable within the ganglion cells in the majority of the lepromatous cases, whereas in the tuberculoid type, such finding was almost nonexistent.4. Axonal hypertrophy, sewelling or destruction of nerve fibers were noted with a fair degree of frequency in both types of the disease.5. Various organs and tissues other than Gasserian ganglia were also examined microscopi-cally to compare the incidence of leprosy bacilli. These viscera included the liver, spleen, adrenals and testes as well as the skin and peripheral nerves. No bacilli were found in any of the organs examined, in the 5 cases of the tuberculoid type. The organiims were demonstrated in the ganglion cells in practically all 12 cases of lepro-matous type showing no significant absorption of cutaneous lesions of nodular infiltra-tion. Leprosy bacilli were also found in other viscera in many of these cases. Of the remaining 8 cases of this type with complete absorption of leprous infiltration and nodules in the skin, 4 were noted to have no evidence of leprosy bacilli in any of the viscera examined while the organisms were still demonstrable in both the peripheral nerves and ganglion cells of 2 other cases.