A Fine Needle Aspiration Study of the Abdominal Cutaneous and Subcutaneous Nodules

Background & Objective: Abdominal cutaneous and subcutaneous nodules are uncommon lesions which may be benign or malignant. Majority of the malignant nodules are metastatic in origin and may be the initial presentation of primary malignancy, hence an early diagnosis is important. Our aim was to find out the spectrum of lesions (both non-neoplastic and neoplastic) that present as cutaneous and subcutaneous abdominal wall nodules and to assess the efficacy of fine needle aspiration cytology (FNAC) in early diagnosis of all such lesions so that need for histopathology can be minimized. Material and Methods: The study was conducted on 46 patients of all age groups, presenting with various palpable cutaneous and subcutaneous abdominal wall nodules. FNAC was performed, smears stained with May GrunwaldGiemsa stain and Pap stains. Special stains were applied wherever required. Cytological diagnosis was subsequently correlated with histopathological diagnosis. Results: Out of 46 FNAC cases; there were 13 non-neoplastic lesions, 15 benign neoplasms and 17 malignant lesions. One case was inadequate for opinion that on histopathology turned out to be metastatic deposits from renal cell carcinoma. The rate of unsatisfactory FNAC was 2.2% and the sensitivity was 89.47%. The specificity and positive predictive value was 100%. Conclusion: FNAC is a simple, minimally invasive, highly accurate and cost effective technique for quick diagnosis of malignant metastatic abdominal wall nodules, thus minimising the need for histopathology and for deciding mode of treatment.