Histopathologic features of cutaneous leishmaniasis and use of CD1a staining for amastigotes in Old World and New World leishmaniasis

Sundharkrishnan, Lohini; North, Jeffrey P.

doi:10.1111/cup.13032

Cited by 28 publications

(37 citation statements)

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“…The known positivity of amastigotes for some clones of anti-CD1a antibody 23,24 has been used as a surrogate to specific anti-Leishmania antibodies, although different Leishmania species seem to show variable positivity with these antibodies. 25 In recent years, molecular techniques based on PCR have shown to be the most sensitive method for the diagnosis of leishmaniasis, 9,12,26 allowing, in addition, typing of Leishmania species, 11,[26][27][28] which is particularly important in areas with more than one endemic species and in cases of imported leishmaniasis. PCR has proved its effectiveness in different kinds of samples, 11,26,29 including FFPE biopsies.…”

Section: Resultsmentioning

confidence: 99%

Cutaneous leishmaniasis: A pathological study of 360 cases with special emphasis on the contribution of immunohistochemistry and polymerase chain reaction to diagnosis

et al. 2020

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Background: Traditional methods for the diagnosis of leishmaniasis yield poor sensitivity, which limits its effectiveness in lesions with a low parasite burden. Methods: Retrospective pathologic study of 360 cases of cutaneous leishmaniasis and analysis of the different diagnostic methods used. Results: In 93% of the lesions, histopathology showed a dense and diffuse inflammatory infiltrate, consisting of lymphocytes, histiocytes and plasma cells, which occupied the superficial and mid dermis and variably extended to deep dermis and superficial subcutis (standard pattern). The remaining cases exhibited atypical features, such as perivascular, interstitial or perifollicular inflammatory patterns, folliculitis or panniculitis. Granulomas were identified in 84% of biopsies, most of them as small, poorly formed, non-necrotizing histiocytic aggregates. Amastigotes were visualized by routine histopathologic exam in 36% of biopsies. Immunohistochemistry stained 17 of 26 lesions (65%) negative by conventional stains. PCR provided the correct diagnosis in 218 cases (58% of the series) negative for Leishmania by other techniques. Conclusions: Biopsies negative for Leishmania by traditional diagnostic methods that show the histopathologic standard pattern, those with atypical features from patients with clinical suspicion of cutaneous leishmaniasis in endemic areas, should be studied by immunohistochemistry and/or PCR for Leishmania in order to reach the definitive diagnosis.

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Section: Resultsmentioning

confidence: 99%

Cutaneous leishmaniasis: A pathological study of 360 cases with special emphasis on the contribution of immunohistochemistry and polymerase chain reaction to diagnosis

et al. 2020

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“…1 CD1a staining can be used to facilitate diagnosis, although existing studies have demonstrated CD1a staining to be insensitive in cases of New World CL, with only 44% positivity. 5 Previous studies have indicated that PCR is the single most sensitive assay for diagnosis of CL (up to 100%), 6,7 although it is less specific (86%-96%) than tissue culture (100%) and histopathology (100%). 6,7 Therefore, we sent the fixed tissue sample from the biopsy completed 1 year prior to definitive diagnosis to the CDC for retrospective PCR analysis.…”

Section: Discussionmentioning

confidence: 99%

A rare case of lupoid leishmaniasis defying diagnosis for a decade

Gehlhausen

Sibindi

et al. 2020

J Cutan Pathol

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“…In this issue of the Journal of Cutaneous Pathology , Sundharkrishnan and North present data on immunostaining of Leishmania amastigotes by CD1a, including species from the New and the Old World . This editorial will put these findings into the context of our current knowledge of leishmaniasis.…”

Section: Conflict Of Interestmentioning

confidence: 94%

A new scenario in the immunohistochemical diagnosis of cutaneous leishmaniasis

Fernández-Flores

2017

J Cutan Pathol

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Cutaneous lesions of leishmaniasis are easy to diagnose when clinically obvious or when amastigotes are numerous in the biopsy. However, this is not always the case. In difficult cases, the diagnosis of leishmaniasis requires a reliable tool to identify the microorganisms. The identification of the parasite via microscope has a superior sensitivity to that of culture, and molecular techniques, such as polymerase chain reaction (PCR), highly improve the sensitivity of the diagnosis. Alternatively, immunohistochemistry has emerged as an affordable alternative to PCR. Several laboratories have produced their own antibodies against Leishmania and seem satisfied with the results. Nevertheless, most of these antibodies are not commercialized or standardized. Pathology also welcomed the unexpected positivity of amastigotes with certain clones of anti-CD1a. The latter does not universally stain all species of Leishmania, with a low sensitivity for New World species. In conclusion, although anti-CD1a is a reliable complementary tool in the diagnosis of leishmaniasis, pathologists should familiarize themselves with one of the specific antibodies against Leishmania and globalize its use, standardizing and adapting the technique.

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Histopathologic features of cutaneous leishmaniasis and use of CD1a staining for amastigotes in Old World and New World leishmaniasis

Cited by 28 publications

References 11 publications

Cutaneous leishmaniasis: A pathological study of 360 cases with special emphasis on the contribution of immunohistochemistry and polymerase chain reaction to diagnosis

Cutaneous leishmaniasis: A pathological study of 360 cases with special emphasis on the contribution of immunohistochemistry and polymerase chain reaction to diagnosis

A rare case of lupoid leishmaniasis defying diagnosis for a decade

A new scenario in the immunohistochemical diagnosis of cutaneous leishmaniasis

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