Evaluation of cytodiagnosis of cutaneous basal cell carcinoma

Cytologic and histopathologic diagnoses were assessed independently without clinical details in 150 lesions from 112 consecutive patients. Nine of the lesions (6%) could not be evaluated cytologically because of unsatisfactory smears. Correct cytodiagnosis was obtained in 125 of 141 (89%) evaluable lesions. A solar keratosis with prominent basal cell hyperplasia was incorrectly assessed as a basal cell carcinoma (BCC). Five BCCs were misdiagnosed as squamous atypia, either because the smears were not representative or from inability to distinguish between pleomorphic BCC and severe squamous atypia. An incorrect cytologic diagnosis was thus made in 4% of lesions. Smears from ten lesions (7%) were reported as nondiagnostic for the same reasons. Cytologic diagnosis is simple, rapid, and accurate and is of value in the management of suspected cutaneous BCC.