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Cellular Atypia in a Rheumatoid Nodule: A Diagnostic Pitfall of Aspiration Biopsy

YOUNGBERG, GEORGE A. M.D.¹; FARNUM, JAMES B. M.D.²

¹ George A. Youngberg, M.D., is Surgical Pathologist, VAMC Mountain Home and Assistant Professor of Pathology, East Tennessee State University College of Medicine.

² James B. Farnum, M.D., is Chief of Anatomic Pathology, VAMC Mountain Home and Assistant Professor of Pathology, East Tennessee State University College of Medicine.

Address reprint requests to George A. Youngberg, M.D., East Tennessee State University, Dept. of Pathology, Box 19540A, Johnson City, TN 37614–0002.

The Journal of Dermatologic Surgery and Oncology 10(2):p 128-132, February 1984. | DOI: 10.1111/j.1524-4725.1984.tb01197.x

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Abstract

A 63-year-old cachectic white male developed subcutaneous scalp nodules. Clinically these were felt most likely to represent metastatic tumor, although the patient was known to have rheumatoid arthritis. Aspiration cytology was interpreted as malignant due to the presence of atypical cells, but tissue biopsies demonstrated necrotizing palisading granulomas. The diagnostic hazard of cellular atypia in rheumatoid nodules is discussed.