Fine needle aspiration cytology in dermatology: a clinicopathological appraisal

The possible clinical value of fine needle aspiration cytology (FNAC) has been assessed prospectively in 60 patients presenting with cutaneous lesions. The cytological diagnosis in each case has been compared with the clinical diagnosis and biopsy result. The principal potential use appears to be the rapid confirmation of the clinical diagnosis of basal cell carcinoma to allow immediate referral for radiotherapy or plastic surgery. FNAC could also prove useful when the clinical diagnosis of malignant melanoma is in doubt and primary diagnostic excision is difficult or disfiguring. Accurate distinction could usually be made between benign and malignant lymphoproliferative conditions, but further classification was difficult. Metastatic malignancy could be diagnosed with ease and other characteristic cytological appearances were seen with naevocellular naevi, pyogenic granuloma and pilar cysts. However, there were limitations in achieving an accurate diagnosis in approximately half the cases, and consequently, FNAC cannot be regarded in general as a substitute for histological diagnosis.