Lesional fine needle aspiration (FNA) cytology in reactional and non-reactional leprosy patients

Fine needle aspiration cytology (FNAC) is a relatively simpler tool as compared to histopathology for the evaluation of the cytomorphology of skin lesions. Fifty consecutive leprosy patients diagnosed and classified according to Ridley Jopling scale1 were taken to study the cytomorphology of leprosy lesions in fine needle aspirates and correlate it with their histopathology by a skin biopsy from the same site for histopathological examination after H/E staining. Borderline leprosy patients with Type I reaction showed significantly more numbers of giant cells, collagen and elastin in their smears as compared to those without reaction. The smears were more heavily cellular with fragmented collagen and elastin along with significant increase in neutrophils in patients with Type II reaction while foamy macrophages with fatty background were common in non-reactional lepromatous leprosy patients. A complete correlation between histopathological and cytomorphological findings was observed in 79.4% of cases.