THE UTILITY OF FINE-NEEDLE ASPIRATION IN THE DIAGNOSIS OF MELANOMA METASTATIC TO LYMPH-NODES

Background: Prompt and accurate diagnosis of melanoma metastatic to th e lymph nodes is important with respect to prognosis and treatment. Ob jective: The purpose of this study was to determine the utility and di agnostic reliability of fine needle aspiration (FNA) of enlarged nodul es in lymph node basins in patients with melanoma. Methods: We retrosp ectively reviewed the charts of 46 patients with melanoma who underwen t a total of 56 FNAs of palpable nodules in lymph node basins. Results : Of the 56 FNAs, 24 showed melanoma, 26 did not demonstrate melanoma, five were inadequate, and one gave inconclusive but suspect results. Findings were confirmed by open biopsy (n = 35) or clinical follow-up (n = 21). Fifty of 56 FNAs (89%) yielded a definitive diagnosis (sensi tivity/specificity = 100% in these 50). Conclusion: FNA biopsy of enla rged palpable nodules in nodal basins in patients with melanoma is acc urate, rapid, and cost-efficient. An algorithm for management of patie nts with melanoma who have palpable nodes is provided.