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Published on: October 30, 2010
Utility of fine-needle aspiration in the diagnosis of panniculitis
J García-Solano1, B García-Rojo, C Sánchez-Sánchez
1Department of Pathology, Rosell Hospital, Cartagena, Spain.
Abstract:
This is a retrospective reassessment of the most important cytopathologic features of 23 FNA smears with a cytologic diagnosis of panniculitis (PN). Patients were sent by clinicians. Clinical diagnoses were as follows: 16 suspicious of PN; three cutaneous metastases of an extracutaneous primary neoplasm; four with no clinical diagnosis. Thirteen cases were subsequently submitted to histopathologic study. The following cytoarchitectural patterns were found to be very useful for the cytologic diagnosis of PN: adipocytes intermingled with foamy histiocytes, donut-like granulomas, aggregates of adipocytes intermingled with plump histiocytes, a granular basophilic background forming a lattice-like pattern, and well-formed granulomas with or without multinucleated giant cells. Inflammatory cells could be seen combined with any of these cytoarchitectural patterns. FNA does not pretend to replace excisional biopsy as the diagnostic procedure for these entities but it is a very useful diagnostic tool in certain cases: for confirming the recurrence of PN previously diagnosed by histology, for evaluating the onset of subcutaneous nodules in patients with a non-cutaneous malignant primary neoplasm, for evaluating cutaneous nodules with no clinical suspicion, and for confirming a clinical diagnosis of PN and differentiating it from other entities that mimic PN clinically.
Insights
Fine-needle aspiration (FNA) cytology is a valuable tool for diagnosing panniculitis (PN). Key cytopathologic features like adipocytes, histiocytes, and granulomas aid in accurate PN diagnosis.
Area of Science:
- Cytopathology
- Dermatopathology
- Surgical Pathology
Background:
- Panniculitis (PN) diagnosis can be challenging, often requiring histopathologic confirmation.
- Fine-needle aspiration (FNA) offers a less invasive approach for evaluating subcutaneous lesions.
Purpose of the Study:
- To retrospectively analyze key cytopathologic features of FNA smears for diagnosing panniculitis (PN).
- To assess the utility of FNA in differentiating PN from other subcutaneous conditions.
Main Methods:
- Retrospective review of 23 FNA smears with a cytologic diagnosis of panniculitis.
- Correlation of cytologic findings with clinical and histopathologic diagnoses.
- Identification of characteristic cytoarchitectural patterns indicative of PN.
Main Results:
- Specific patterns identified: adipocytes with foamy histiocytes, donut-like granulomas, aggregates of adipocytes with plump histiocytes, lattice-like basophilic background, and granulomas.
- Inflammatory cells were observed in conjunction with these patterns.
- FNA proved useful in confirming PN recurrence, evaluating nodules in cancer patients, and assessing clinically ambiguous lesions.
Conclusions:
- FNA cytology is a useful adjunct for diagnosing panniculitis, complementing histopathology.
- Recognizing specific cytopathologic features enhances diagnostic accuracy for PN and its mimics.
- FNA provides valuable diagnostic information in specific clinical scenarios involving subcutaneous nodules.
