title: Ultrasound-guided fine-needle aspiration cytology in the early detection of melanoma metastases.
abstract: BACKGROUND
  The early detection and treatment of tumor recurrences in melanoma patients is dependent on reliable, sensitive, and specific techniques to verify suspected tumor metastases. As of now, fine-needle aspiration cytology (FNAC) has yet to establish itself in the routine follow-up of melanoma patients.
  
  
  METHODS
  FNAC procedures were performed in melanoma patients with palpable tumors or nonpalpable, ultrasonically suspicious lesions. Cytodiagnostic evaluation of fine-needle samples obtained from suspicious lesions was performed morphologically. Findings were validated either by histopathologic diagnosis or prolonged clinical follow-up.
  
  
  RESULTS
  The cytologic examination of 739 FNACs from 330 melanoma patients was conducted within 1 day of sampling. Complications were not observed. This study showed a sensitivity of 97.9% and a specificity of 100.0%. Moreover, in 158 FNACs derived from lesions with a diameter less than 1 cm a sensitivity of 94.6% was achieved. Diagnosis of metastatic melanoma with unknown primary tumor was established in 20 cases.
  
  
  CONCLUSIONS
  FNAC is very reliable for the early detection of melanoma metastases. FNAC is a swift method free of complications and is able to replace diagnostic surgery completely for nonmalignant lesions in a large number of patients. Moreover, FNAC is especially useful in combination with ultrasound in melanoma follow-up and can enable diagnosis of lesions smaller than 1 cm without impairment of sensitivity or specificity.
authors.affiliation: Department of Dermatology, Charité, Humboldt University of Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Voit
authors.forename: T
authors.initials: T
authors.lastname: Mayer
authors.forename: T M
authors.initials: TM
authors.lastname: Proebstle
authors.forename: L
authors.initials: L
authors.lastname: Weber
authors.forename: M
authors.initials: M
authors.lastname: Kron
authors.forename: M
authors.initials: M
authors.lastname: Krupienski
authors.forename: U
authors.initials: U
authors.lastname: Zeelen
authors.forename: W
authors.initials: W
authors.lastname: Sterry
authors.forename: A
authors.initials: A
authors.lastname: Schoengen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D009367:Neoplasm Staging / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000592:standards