Development of Highly Organized Lymphoid Structures in Buruli Ulcer Lesions after Treatment with Rifampicin and Streptomycin
Figure 4
Histopathology of four patients in response to rifampicin/streptomycin bi-therapy.
Histological sections representative for four patients stained with HE (A, C, D, E) and polyclonal antibody against proliferation marker Ki67 (B). Magnification ×40 (A, C, E) and ×100 (B, E). (A) Psoriatic epidermal hyperplasia typically seen in Buruli. Diffuse mixed cellular infiltrates in upper and granuloma formation with Langhans' giant cells lymphocytes in deeper dermis. (B) Ki67 staining reveals elevated proliferation levels of keratinocytes in epidermal basal layer. (C) Cell ghosts of the adipose tissue characteristic for Buruli infection. Massive mixed cellular infiltrates between fat ghosts mainly consisting of macrophages/monocytes and formation of new blood vessels. (D) Necrotic area in deep tissue encircled by extensive cellular infiltrates. (E) Focal eosinophilia found at margins of the excised area distant to ulcerative centre.