Diagnosing granulomatous inflammation of the skin. A cytomorphologic approach based on evaluation of cellular...

To determine the applicability of recognizing cellular reaction patterns in the cytologic diagnosis of granulomatous inflammation of the skin.

Prospective. Two hundred seventeen cases of clinically suspected granulomatous dermatitis formed the data for this study. May-Grünwald-Giemsa, Ziehl-Neelsen, periodic acid-Schiff, silver impregnation and Gram staining methods were employed.

Five cytomorphologic patterns of granulomatous inflammation were identified: epithelioid cell granulomas (77), histiocytic granulomas (20), epithelioid cell granulomas with polymorphous exudate (77), foreign body granulomas (3) and fat necrosis with granulomas (9).

Correlating clinical presentation with cytomorphologic patterns often yields diagnostic information in the workup of granulomatous inflammation of the skin and frequently obviates the need for biopsy.