Diagnostic Utility of FNAC in Cutaneous Adnexal Tumors: A Cytohistomorphological Correlation in 21 Cases

Abstract Background: Skin adnexal tumors (SATs) are uncommon neoplasms showing differentiation toward hair follicles, sebaceous glands, or sweat glands. Fine-needle aspiration cytology (FNAC) offers a rapid, minimally invasive diagnostic approach, though histopathology remains the gold standard. Aim: To correlate cytological features with histopathological findings in SATs. Materials and Methods: A prospective study was conducted over 18 months (July 2022–December 2023) in the Department of Pathology of a tertiary health care center. Twenty-one cases with both FNAC and histopathology were included. FNAC smears were stained with hematoxylin & eosin, Papanicolaou, and May–Grünwald–Giemsa. Biopsy specimens were processed and examined histologically. Special stains and immunohistochemistry were used when necessary. Cytohistological correlation was classified as complete, partial, or absent. Results: Of 517 skin biopsies, 29 were diagnosed as SATs on histopathology. The FNAC correlation was available in 21 cases only, and so these cases were included in the study. Nineteen were benign (90.5%), and two were malignant (9.5%). The group in their 20s was the most commonly affected (33%). Males outnumbered females (2:1). The head and neck region was the most common site. A complete correlation was observed in 42.8% of cases, partial correlation in 23.8%, and no correlation in 33.4%. Inadequate smears and overlapping morphology contributed to diagnostic discrepancies. Conclusion: FNAC, although limited in some cases, is valuable in differentiating benign from malignant cutaneous nodules. A clinico-cytohistological approach improves diagnostic accuracy and guides appropriate management.