PATHOLOGICAL CHANGES 



307 



legs. These nodules enlarge and produce great distortion of the 

 surface, so that, in the case of the face, an appearance is produced 

 which has been described as " leonine." The thickenings occur 

 chiefly in the cutis (Fig. 89), to a less extent in the subcutaneous 

 tissue. The epithelium often becomes stretched over them, 

 and an oozing surface becomes developed, or actual ulceration 

 may occur. The cornea and other parts of the eye, the mucous 





FIG. 89. Sections through leprous skin, showing the masses of 

 cellular granulation tissue in the cutis ; the dark points are cells 

 containing bacilli deeply stained. 



Paraffin section ; Ziehl-Neelsen stain, x 80. 



membrane of the mouth, larynx, and pharynx, may be the seat 

 of similar nodular growths. Internal organs, especially the 

 spleen, liver, and testicles, may become secondarily affected. In 

 all situations the change is of the same nature, consisting in an 

 abundant formation of granulation tissue, nodular or diffuse in 

 its arrangement. In this tissue a large proportion of the cells 

 are of rounded or oval shape, like hyaline leucocytes ; a number 

 of these may be of comparatively large size, and may show 

 vacuolation of their protoplasm and a vesicular type of nucleus. 

 These are often known as "lepra-cells." Amongst the cellular 



