Cytomorphological spectrum of scalp lesions in the population of a developing country: A retrospective study

Abstract

BACKGROUND Scalp lesions are frequently encountered in clinical practice. Fine‐needle aspiration cytology (FNAC) can characterize most of these lesions; however, there is little published work on cytology of scalp lesions. METHODS Records of all the patients subjected to FNAC from January 2011 to August 2016 were retrieved from the archives of the Cytopathology section of our Institute. Out of the 71 852 cases reviewed, 896 patients, who presented with palpable scalp lesions, were included in the study. Aspirates were obtained with a 23‐gauge needle attached to a 10 mL disposable plastic syringe. May–Grünwald–Giemsa stained and Pap stained slides were prepared. Special stains and immunocytochemical analysis were done when necessary. RESULTS Out of the 896 cases of aspirates from scalp lesions, 155 (17.2%) aspirates were found to be inadequate for diagnosis. One hundred and fifty‐seven (21%) out of 741 adequate aspirates showed features of inflammatory or reactive pathology comprising of abscesses (57), cystic lesions (24), tubercular lesions (16), and reactive lymphadenopathy (66). Four hundred and fifteen (56%) aspirates revealed a tumor‐like etiology comprising of epidermal cyst (395), sebaceous cyst (4), dermoid cyst (1), calcinosis (7), vascular malformation (7), hematoma (5), and juvenile xanthogranulomatous lesion (1). Tumorous lesions formed 22.3% of the aspirates. Of these, 7 cases (4.2%) were of metastases to the scalp. CONCLUSION In a developing country, FNAC is a useful and cost‐effective investigation for the diagnosis of a wide spectrum of scalp lesions. It allows rapid diagnosis and permits timely intervention thereby preventing complications due to delay in diagnosis.

Fine‐needle aspiration of scalp masses: A review of 30 cases

“…Findings concerning for malignancy include lesions that are hard, painful, rapidly growing, and involving the underlying bone 2 . The scalp is a common site of metastasis, accounting for 4%–7% of all cutaneous metastasis, with lung and breast carcinomas being the most frequently reported tumor types 3–7 …”

“…2 The scalp is a common site of metastasis, accounting for 4%-7% of all cutaneous metastasis, with lung and breast carcinomas being the most frequently reported tumor types. [3][4][5][6][7] Fine-needle aspiration (FNA) is a rapid, cost-effective, and minimally invasive technique that is ideal for diagnosing superficial lesions of the scalp. 2,[8][9][10][11] It allows for optimal triaging of patient specimens for ancillary testing such as cultures for microbiology, flow cytometry for suspected lymphoma, or additional passes for cell block preparation to perform immunohistochemical and molecular studies.…”