Diagnostic utility of FNAC in gouty tophi with review of literature

Periarticular nodules have the variety of differential diagnosis including inflammatory to neoplastic conditions. Amongst these, gouty tophus is an important differential diagnosis. Fine needle aspiration cytology (FNAC) is a valuable diagnostic tool for the diagnosis of periarticular nodules. We presented here a case of 48 years old male with multiple soft tissue nodules in extremities. Case was evaluated clinically and FNAC was advised. Fine needle aspiration revealed chalky white aspirate. The case was studied and data was collected in month of October 2013. After staining the smear with Hematoxylin and Eosin (H&E), needle shaped crystals were seen in amorphous granular debris. Diagnosis of gouty tophi was made. On further workup, serum uric acid levels were found to be high and a diagnosis of gout was established. FNAC is an easy, minimally invasive and cost effective procedure for diagnosing gouty tophus and is replacing biopsy for the diagnosis of gouty tophus.