The utility of fine needle aspiration in the diagnosis of melanoma metastatic to lymph nodes

Background: Prompt and accurate diagnosis of melanoma metastatic to the lymph nodes is important with respect to prognosis and treatment. Objective: The purpose of this study was to determine the utility and diagnostic reliability of fine needle aspiration (FNA) of enlarged nodules in lymph node basins in patients with melanoma. Methods: We retrospectively reviewed the charts of 46 patients with melanoma who underwent 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 (sensitivity/specificity = 100% in these 50). Conclusion: FNA biopsy of enlarged palpable nodules in nodal basins in patients with melanoma is accurate, rapid, and cost-efficient. An algorithm for management of patients with melanoma who have palpable nodes is provided.