Pitfalls in the diagnosis of Wegener's granulomatosis on fine needle aspiration cytology.
OBJECTIVE
To review the clinical and pathological findings in six suspected cases of Wegener's granulomatosis (WG) and highlight the diagnostic difficulties faced by the cytopathologist.


METHODS
Retrospective review of records of the Cytopathology Department to identify patients who underwent image-guided transthoracic pulmonary fine needle aspiration cytology (FNAC) for pulmonary lesions of suspected WG and those who were subsequently confirmed to have WG. Detailed evaluation of cytomorphological features was carried out.


RESULTS
A total of six cases were identified in whom the initial procedure to obtain a pathological diagnosis was transthoracic FNAC. In one case, atypical squamous cells on cytology initially suggested a diagnosis of squamous cell carcinoma while in another a diagnosis of WG was made on cytology; however, a subsequent lung biopsy revealed silicosis.


CONCLUSIONS
Acute inflammation and necrosis are the most consistent cytopathological findings in WG. In selected cases FNAC can provide supportive pathological evidence to establish a diagnosis of WG.
Awasthi
A
A
Deapartment of Cytopathology, Postgraduate Institute of Medical Education and Research, Chandiharh, India.
Malhotra
P
P
Gupta
N
N
Gupta
D
D
Rajwanshi
A
A
D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies