중동지방에 다녀온 48세의 한국인 남자 피부에 발생한 leishmania증 1예에 대하여 광학 및 전자현미경적 관찰을 하여 문헌 고찰과 아울러 보고하였다. 광학현미경적으로는 조직구 침윤을 주로 하는 만성 육아종성염증반응을 보였고 Giemsa염색상 다수의 leishmania충체를 조직구내에서 관찰할 수 있었다. 전자현미경적으로는 난원형의 단세포 또는 분열중인 충체가 조직구내에 존재하였고 충체는 이중막으로 싸였으며 그 바로밑에 microtubule이 배열되고 세포질내에는 신장된 mitochondrion내에 kinetoplast가 존재하고 그 전방에 flagella가 위치하였으며 기타 다수의 ribosome과 드물게 Golgi complex등을 관찰할 수 있었다. 이와같은 특징은 Leishmania tropica의 promastigote stage와 일치하였다. Leishmania증은 원칙적으로 열대병이나 열대지방과의 접촉이 빈번함에 따라 앞으로 우리나라에서도 보다 많은 증예가 발생할 것으로 사료된다.
A case of cutaneous leishmaniasis developed in a 48 year old Korean male who returned from middle east was studied by light and electron microscopic observations. Light microscopically, the lesion consisted of heavy chronic ill-defined granulomatous inflammation involving entire thickness of the dermis, composed of mainly histiocytic and small mononuclear cell infiltrations without evidence of necrosis or giant cell formation. Giemsa staining revealed numerous intracellular micro-organisms within histiocytes, showing dark stained central dot surrounded by light stained cytoplasm. Electron microscopically, the organisms were observed mostly ovoid in shape and frequently binary mitotic features within the host cells. follicle consisted of double unit membranes and microtubules, which are immediately below these membrnae. A long kinetoplast was noted within a very elongated mitochondrion at the center of the organisms and a flagella rose in front of the kineoplast but ended within the cytoplasm. Large numbers of free ribosomes, occasional Golgi complex and SER were also noted, but RER was seldom found. These ultrastructural features corresponded to promastigote stage of Leishmania tropica. In principle, leishmaniasis is a tropical disease and can not be found in temperate zone. However, travel to mideast by many Koreans may contract this disease while they are in endemic regions.
