Fine needle aspiration of epididymal nodules in Chandigarh, north India: an audit of 228 cases N. Gupta, A. Rajwanshi, R. Srinivasan and R. Nijhawan Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Accepted for publication 12 May 2005 N. Gupta, A. Rajwanshi, R. Srinivasan and R. Nijhawan Fine needle aspiration of epididymal nodules in Chandigarh, north India: an audit of 228 cases Background Epididymal nodules are not infrequently encountered in surgical practice. These are generally small and slippery and fine needle aspiration cytology (FNAC) is not easy. But as it is rapid and less traumatic than a biopsy, this is a favoured technique in the assessment of epididymal nodules. Patients and methods In the present study, all the cases of epididymal nodules aspirated from January 1998 to August 2004 were retrieved from the cytology files of the Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Results A total of 228 cases were retrieved and divided as follows: tuberculous epididymitis 70 (30.7%), non- specific inflammation 10 (4.4%), microfilaria 2 (0.9%), hydrocele 26 (11.4%), spermatocele 42 (18.4%), spermatic granulomas 12 (5.3%), adenomatoid tumour 3 (1.3%), leiomyosarcoma 1 (0.4%) and lipoma 1 (0.4%). Thirty-six (15.8%) cases were labelled as benign aspirate not otherwise specified. FNAC material was inadequate for opinion in 22 (9.65%) cases and three (1.3%) cases revealed evidence of a haematoma. Conclusions FNAC was useful in the diagnosis of 90.3% of cases, thereby avoiding surgical biopsy and other investigations. Therefore, FNAC has an important role in the differential diagnosis of epididymal nodules as it can detect malignancy and benign conditions such as tuberculosis and acute and chronic epididymo-orchitis. Keywords: epididymal nodules, FNAC, spermatic granuloma, tuberculosis, spermatocele, adenomatoid tumour Introduction Fine needle aspiration cytology (FNAC) is a widely acclaimed safe outpatient procedure, which has been used for the early diagnosis of palpable and non- palpable lesions. There are, however, a few body sites where the role of aspiration cytology has not yet been fully evaluated. The diagnostic reliability of FNAC in the genital area is well known. 1 As epididymal nodules are generally small and slippery, FNAC is not easy. However, FNAC has a definite role in the differential diagnosis of epididymal nodules and it is rapid and less traumatic than a biopsy. By providing an accurate and rapid diagnosis, FNAC prevents aggressive and potentially inappropriate surgical pro- cedures. 1–3 Distinction of spermatic granulomas from the more common tuberculous granulomatous infec- tion is important. Clinically, these lesions may mimic neoplastic epididymal nodules. 2 Diagnosis of malig- nancy is important and can be achieved on FNAC. 1,2 Therefore, FNAC bridges the diagnostic gap between initial palpatory examination and histological diagno- sis and can greatly reduce the need for diagnostic surgery. Methods The cases were retrieved from the records of the Department of Cytology and Gynaecological Patho- logy, Postgraduate Institute of Medical Education and Research, Chandigarh. A total of 228 aspirations from the epididymis were performed from January 1998 to August 2004. Clinical information including age and presenting symptoms were recorded. The cases clin- ically presented as epididymal nodules ranging from Correspondence: Dr A. Rajwanshi, Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India. Tel.: +91 172 2755117; Fax: +91 172 2744401; E-mail: arvindrajwanshi@hotmail.com Cytopathology 2006, 17, 195–198 ª 2006 Blackwell Publishing Ltd 195