Noma in an Egyptian mummy? • 301 



genie eonneetion could be postulated 

 for the following reasons: ( 1 ) most of 

 the lesions (I, II, IV) are located in the 

 right part of the face; (2) lesion V is 

 located on the level of the middle group 

 of the nodi lymphatici cervicales pro- 

 fundi which collect the lymph coming 

 from the head and neck region; (3) the 

 discussed diseases cause a more or less 

 severe reaction of the lymphatic sys- 

 tem, that is, lymphoid hyperplasia or 

 ulcerative lymphangitis. 



However, investigation of the mar- 

 gin of lesion V by means of a ster- 

 eoscopic dissecting microscope reveals 

 that no inflammatory or healing process 

 can be detected. Furthermore, it has not 

 been sufficiently proven whether the 

 penetrating defect on the bottom of the 

 cavity exposing the styloid process was 

 caused either intra vilam or post mor- 

 tem. We assume that lesion V corre- 

 sponds to a calcified lymph node cavity 

 (as it is occasionally diagnosed relative 

 to tuberculosis) or to a cystic benign 

 tumor. Any connection with lesions I- 

 IV is conceivable, but not necessary. 

 Due to the brittle surrounding tissue, 

 histological sections could not be pre- 

 pared from this anatomical region. 



Instead of this, and with the aim of a 

 more detailed diagnosis, biopsies of ul- 

 cerations I, II and III were investigated 

 histologically. Besides the partly pre- 

 served epidermis, groups of cellular 

 elements could be observed, which 

 consisted of clusters of either spindle- 

 formed, oval or circular cells (Figures 

 15,16). Erythrocytes and most proba- 

 bly leukocytic infiltrates were identi- 

 fied (Figures 17.18). In Figure 15, 

 tissue surrounds the circular cell cluster 

 (arrows). Most likely it is a vascular 

 wall; therefore, the formation could be 

 interpreted as a cross-section of blood 

 vessels. Despite the application of di- 

 verse staining methods such as Ziehl- 

 Neelsen, Gram, Giemsa, PAS, haema- 

 toxilin-eosin and Azan, it was impossi- 

 ble to get clear indications for the in- 

 volvement of the ulcers by microorgan- 

 isms relating to one of the discussed 

 pathological conditions. One of the 

 problems is that there is no verification 





Wa 



Figures 15-18. Microphotographs (specimen 1565) taken from histological sec- 

 tions (ulceration III): 15, different cell types partly conglomerated into oval cell 

 clusters, Giemsa, x68; 16, cell clusters, Giemsa, x243; 17, close-up of cells from 

 Figure 16, showing possible erythrocytes, Giemsa. x243; 18, close-up of cell-types 

 out of Figure 16, most probably showing leucocytes. Giemsa. x243. 



Figure 19. Nonidentified organic structure with regular internal septations, parasi- 

 tic infection? Giemsa, x243. 



Figures 20,21. Oblong, bacterial (?) elements in chainlike arrangement. Giemsa, 

 X400. 



of the antemortem origin of the worm- 

 like, organic structure and bacterial (?) 

 elements demonstrated in Figures 19- 

 21. It is remarkable, however, that 

 comparative, cutaneous examinations 

 of the same subject as well as our stud- 

 ies of mummified skin preparations 



from other samples of the same mum- 

 my collection did not disclose parallel 

 findings. Unfortunately, there are in- 

 sufficient, satisfactory histopathologi- 

 cal investigations of Egyptian mum- 

 mies' soft tissues at the present time, 

 so that an analysis of the above- 



Zagrrb Pateopathotogy Symp. 1988 



