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Abstract：
Background Syringoma is a benign adnexal neoplasm and is considered safe with very low malignant potential. However, multiple tiny lesions typically affect the face and exposed area, which may cause a cosmetic concern for the patient. After a clinical diagnosis, there are two methods to diagnose syringoma: fine needle aspiration cytology (FNAC) and histopathology. FNAC is generally used for the initial evaluation of syringoma, while histopathology is used as a confirmatory test to diagnose syringoma. In developing and resource-limited settings, the combination of FNAC and histopathology would cause a financial and logistics burden. Objective This study aimed to observe the cytological and histopathological features of cases clinically diagnosed as syringomas in a tertiary care hospital to suggest the use of either FNAC or histopathology for diagnosing syringoma. Materials and Methods This cross-sectional observational study was conducted in the Department of Dermatology and Department of Pathology of a tertiary care hospital in eastern India from November 2021 to April 2022. Any clinically provisionally diagnosed case of syringoma was recruited for the study after obtaining informed consent for voluntary participation. With aseptic precautions, the tissue aspirates and punch biopsy were obtained in the Department of Dermatology and the samples were sent to the Department of Pathology. Cytological and histological examination was conducted by a single expert pathologist. Result A total of 50 cases (36 female, 14 male) with a median age of 23 years (range 10-40 years) were included in the study. A total of 43 cases were presented with papular lesions and seven with nodules. In the majority of the cases (40%), the lesion was in the eyelid followed by 26% in the arm. In FNAC, 22 cases were found to be benign adnexal lesions, 16 were suggestive of syringoma, eight were diagnosed as xanthoma, two were diagnosed as warts, and two cases were inadequate for opinion. Histologically, 42 cases were confirmed as syringoma, six were diagnosed as xanthoma, and two cases were diagnosed as warts. There was a significant difference between diagnosis by FNAC and histopathology (McNemar χ2 = 24.038, p-value = 0.0001). Conclusion We found that FNAC and histopathological diagnosis of syringoma may not be corroborative. Benign adnexal lesions are difficult to categorize by FNAC. Histopathological examination of clinically diagnosed cases of syringoma is of help for definitive diagnosis. Hence, FNAC may be avoided for saving time and discomfort for the patients and clinically diagnosed cases may be diagnosed by histopathological examination.
摘要：
背景：汗管瘤是一种良性附件肿瘤，被认为是安全的，恶性可能性非常低。然而,多个微小病变通常会影响面部和暴露区域，这可能会引起患者的美容问题。经过临床诊断,有两种诊断方法：细针穿刺细胞学（FNAC）和组织病理学。FNAC通常用于汗管瘤的初步评估，而组织病理学被用作诊断汗管瘤的确证试验。在开发和资源有限的环境中，FNAC和组织病理学的结合将造成财务和物流负担。目的本研究旨在观察三级医院临床诊断为汗管瘤的病例的细胞学和组织病理学特征，以建议使用FNAC或组织病理学诊断汗管瘤。材料与方法本横断面观察性研究于2021年11月至2022年4月在印度东部一家三级保健医院的皮肤科和病理科进行。在获得自愿参与的知情同意后，招募任何临床上临时诊断的汗管瘤病例进行研究。采取无菌预防措施，在皮肤科进行组织抽吸和穿刺活检,并将样本送至病理科.细胞学和组织学检查由一名专家病理学家进行。结果共50例(女性36例,研究包括14名男性），中位年龄为23岁（范围10-40岁）。共有43例出现丘疹性病变，7例出现结节。在大多数情况下（40％），病变位于眼睑，其次是手臂的26％。在FNAC，发现附件良性病变22例，16个暗示了汗管瘤，八人被诊断为黄色瘤，两个被诊断为疣，有两个案例没有足够的意见。组织学上,42例确诊为汗管瘤，六个被诊断为黄色瘤，两例被诊断为疣。FNAC诊断与组织病理学之间存在显着差异（McNemarχ2=24.038，p值=0.0001）。结论FNAC与汗管瘤的组织病理学诊断可能无法证实。良性附件病变难以通过FNAC进行分类。临床诊断的汗管瘤病例的组织病理学检查有助于明确诊断。因此，为了节省患者的时间和不适,可以避免FNAC,并且临床诊断病例可以通过组织病理学检查来诊断。
