Gouty Tophus at Unusual Site Presenting As Soft Tissue Mass Diagnosed By Fine Needle Aspiration Cytology with Review of Literature

Abstract

Fine needle aspiration cytology (FNAC) is becoming a popular clinical practice in diagnosis of soft tissue nodules. We present a case of 58 years old male with bilateral, painless sub cutaneous nodules near the elbow without any clinical and radiological features of arthritis. Serum uric acid levels were found to be marginally high. Fine needle aspiration revealed negatively birefringent needle shaped crystals consistent with monosodium urate crystals in amorphous granular debris. Diagnosis of gouty tophi was given. FNAC is a valuable diagnostic tool for the diagnosis of periarticular nodules and pathologists should be aware of cytological features of gouty tophi, particularly in cases of unusual presentation.