SCALP LESIONS - A REVIEW OF HISTOPATHOLOGIC AND FINE-NEEDLE ASPIRATION BIOPSY FINDINGS

We reviewed surgical and cytological scalp specimens at Loyola Univers ity Medical Center over an 8-year period. The incidence and types of p athologic entities that appeared in the scalp were tabulated, and the roles of surgery and fine-needle aspiration biopsy (FNAB) were investi gated. There were 352 patients with scalp tissue biopsies. There were 41 primary malignancies, and 3 metastatic carcinomas. FNAB specimens w ere obtained from 36 other patients. Of these, 29 specimens showed mal ignant cytology. All of these patients had a previous diagnosis of mal ignancy. Scalp tissue biopsy specimens were far more likely to have a benign diagnosis than were FNAB specimens (P < 0.0001). This differenc e is probably due to the patients' histories and referring physicians. Healthy patients with a scalp lesion will generally present to a derm atologist, who will obtain a tissue specimen. In contrast, a patient w ith a history of malignancy with a scalp lesion will follow up with an oncologist, who may prefer FNAB to surgical procedures in order to di agnose such a lesion rapidly. The scalp is a common repository for met astatic 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.