Value of Cytology of Cutaneous and Subcutaneous Nodules as a Diagnostic Method in Comparison with Histology

Fine needle aspiration biopsy(FNAB) is a well recognized diagnostic method in various organs. Since it is a non-invasive, quick, easy and cost - effective procedure, it is considered suitable for clinical evaluation of various lesions. The goal of this analytical cross-sectional study is to evaluate the value of cytology of cutaneous and subcutaneous nodules as a diagnostic method in comparison with histologic findings as a gold standard test. Patients & To achieve this objective, a cytologic study including FNA(Fine Needle Aspiration) and scraping methods was performed on 95 patients who had been referred to Rasoul Akram and Shahid Faghihi hospitals in 2003 with the diagnosis of cutaneous and subcutaneous nodules or masses. Then biopsy specimens were processed and stained with H&E(Haematoxylin & Eosin). The specimens with unavailable histologic results or unsatisfactory samples were omitted from this assessment. The most frequent areas of sampling were face, scalp and extremities in order of frequency. It was also observed that the predominant sex was male by 69.2%. FNA technique was applied to 76.9% of the patients, while scraping technique was performed on the rest of the cases. Lesions found in both cytology and biopsy included benign(86.2%) and malignant(13.8%). In comparison to histology, sensitivity and specificity of cytology to distinguish malignant lesions from benign ones were 88.9% and 98.2% respectively. Positive predictive value(PPV) and negative predictive value(NPV) in cytology were 88.8% and 98.2% respectively. Ultimately, we used a correlation test to discover cytohistologic agreement. In this test Kappa and PV were 0.871 and 0.000 respectively, which confirms acceptable correspondence. Also, this study indicated that cytologic diagnosis corresponded exactly to histologic diagnosis in 76.9% of the samples. The Chi-square test yielded PV=0.000, which suggests suitable agreement. Therefore, based on this study and previous assessments cytology can be considered as a quick, easy, non-invasive and cost-effective method for clinical evaluation of cutaneous and subcutaneous nodules or masses.