Fine Needle Aspiration Cytology (FNAC) as a Fast and Cheap Tool in Dermatologic Routine

Abstract

FNAC is commonly used in endocrinology, otorhinolaryngology and other areas, especially for evaluation of thyroid nodules, head and neck masses, enlarged lymph nodes and salivary gland abnormalities. Although FNAC is not a common practice in dermatology routine, in this prospective study, ninety-eight patients presenting with palpable lesions were submitted to FNAC and biopsy at the same time. The majority of cases (82 patients) were diagnosed as basal cell carcinoma on cytology, and had 100% of agreement with histopathology. Three cases presented as insufficient material in FNAC and all of them were diagnosed as superficial basal cell carcinoma in histopathology. All cases of squamous cell carcinoma (6 patients) were diagnosed accurately by FNAC. Two cases in our series were diagnosed as keratoacanthoma and due to the clinical correlation with cytopathology the report addressed this compatibility in a note; without the clinic it would be impossible to infer this diagnosis. All four cases of molluscum contagiosum showed characteristic cytopathological aspects and also had 100% of agreement with histopathology. The main potential use appears to be fastest results and confirmation of clinical diagnosis of basal cell carcinoma and squamous cell carcinoma to allow immediate referral for surgery. FNAC could also prove itself useful when the clinical diagnosis of molluscum contagiosum is among the clinical hypotheses, allowing to confirm it by viewing the characteristic intracytoplasmic inclusion bodies (molluscum bodies, or Henderson-Paterson bodies). The number of repeat out-patient clinic attendances could thus be reduced and valuable time saved on biopsy lists.