Scalp lesions. A review of histopathologic and fine-needle aspiration biopsy findings.
We reviewed surgical and cytological scalp specimens at Loyola University Medical Center over an 8-year period. The incidence and types of pathologic entities that appeared in the scalp were tabulated, and the roles of surgery and fine-needle aspiration biopsy (FNAB) were investigated. There were 352 patients with scalp tissue biopsies. There were 41 primary malignancies, and 3 metastatic carcinomas. FNAB specimens were obtained from 36 other patients. Of these, 29 specimens showed malignant cytology. All of these patients had a previous diagnosis of malignancy. Scalp tissue biopsy specimens were far more likely to have a benign diagnosis than were FNAB specimens (P < 0.00001). This difference is probably due to the patients' histories and referring physicians. Healthy patients with a scalp lesion will generally present to a dermatologist, who will obtain a tissue specimen. In contrast, a patient with a history of malignancy with a scalp lesion will follow up with an oncologist, who may prefer FNAB to surgical procedures in order to diagnose such a lesion rapidly. The scalp is a common repository for metastatic tumors, most likely due to its rich vascularity. Awareness of this fact can be useful to dermatologists or oncologists in selecting the better diagnostic procedure for a patient.
Carson
H J
HJ
Section of Cytology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Gattuso
P
P
Castelli
M J
MJ
Reddy
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D003880:Dermatology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D012189:Retrospective Studies; D012535:Scalp / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D012536:Scalp Dermatoses / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery