An unusual presentation of leprosy: Lepromatous lymphadenitis

Leprosy is a nonfatal, chronic inflammatory disease caused by Mycobacterium leprae, whose clinical manifestations are largely confined to the skin, peripheral nervous system, upper respiratory tract, eyes, and testes.

However, here we are reporting a case of leprosy in a 45-year-old male, who presented with bilateral inguinal lymphadenopathy.

Left inguinal lymph node was excised surgically and was transported in 10% formalin. Sections were stained with Hematoxylin and Eosin and with modified Ziehl–Neelsen (ZN) technique and were examined under light microscope.

Microscopic examination revealed aggregates of foamy histiocytes surrounded by plasma cell infiltrate. Modified ZN stain was performed which showed foamy histiocytes packed with acid-fast lepra bacilli.

This report highlights the importance of systemic involvement in leprosy, especially the unusual presentation with lymphadenopathy. Hence, clinicians practicing in endemic areas should bear this fact in mind.