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Lymph node involvement is not common in leprosy which tends to involve cooler acral regions. However, patients with impaired cellular immunity may develop lepromatous form of leprosy in which generalized lymphadenopathy can occur. In the involved lymph nodes, the lymphocytes in the paracortical areas are replaced by sheets of foamy histiocytes (Lepra cells) which may contain large number of mycobacteria.