Cytological spectrum of suppurative cutaneous and subcutaneous nodules: a one-year retrospective observational study at a tertiary care hospital.

Dr. Lakshmi Saraswathi  Boni; Dr. Sasikala  Salikanti; Dr. Sandhya  Pitla; Dr. Satyanarayana  Polisetty

doi:10.51168/sjhrafrica.v6i12.2265

Authors

Dr. Lakshmi Saraswathi Boni Associate Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India
Dr. Sasikala Salikanti Assistant Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India
Dr. Sandhya Pitla Assistant Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India
Dr. Satyanarayana Polisetty Professor and Head, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2265

Keywords:

Fine Needle Aspiration Cytology (FNAC), suppurative nodules, abscess, keratinous cyst, fungal abscess, cold abscess, cytomorphology

Abstract

Background:
Suppurative cutaneous and subcutaneous nodules frequently resemble a wide range of inflammatory and neoplastic lesions, making early diagnosis essential. Fine needle aspiration cytology (FNAC) provides a rapid, minimally invasive method to identify the underlying pathology and guide timely clinical management.

Objectives:
To describe the cytomorphological spectrum of suppurative nodules and correlate these findings with demographic patterns, lesion size, and anatomical distribution.

Methods:
A retrospective review of 124 FNAC samples obtained from cutaneous and subcutaneous nodules over a one-year period was conducted. Demographic details, clinical features, and cytological characteristics were retrieved from departmental archives. Smears were examined for cellularity, inflammatory profile, necrotic background, keratinous material, fungal elements, and granulomatous reactions. Frequencies and percentages were calculated to summarize diagnostic categories and site distribution.

Results:
Among the 124 patients, males predominated, and most cases occurred between the fourth and seventh decades. Abscesses were the most frequent lesions, followed by infected keratinous cysts, fungal abscesses, and cold abscesses. Truncal lesions were common in abscesses and keratinous cysts, while fungal abscesses occurred primarily in the extremities. All cold abscesses were confined to the head and neck region. Cytological evaluation revealed distinctive patterns for each entity, enabling differentiation between acute suppuration, chronic inflammation, and specific infections such as mycoses or tuberculosis.

Conclusion:
FNAC remains a valuable frontline diagnostic tool for suppurative nodules, offering quick, reliable, and cost-effective insights. Distinct cytomorphological features support accurate classification and help avoid diagnostic confusion with neoplastic lesions, thus promoting early and appropriate treatment.

Recommendations:
Routine FNAC should be encouraged in all unexplained nodular swellings to prevent diagnostic delays. Incorporating microbiological correlation, especially in recurrent or atypical lesions, can strengthen diagnostic precision. Periodic training in recognizing subtle cytological clues will enhance reporting consistency and clinical impact.

Author Biographies

Dr. Lakshmi Saraswathi Boni, Associate Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India

is an Associate Professor in the Department of Pathology at Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India. She completed her MBBS at Andhra Medical College, Visakhapatnam (1995–2001), followed by MD Pathology at Rangaraya Medical College, Kakinada (2004–2007). She served as Assistant Professor at Andhra Medical College from 2015 to 1 March 2023 and has been working as Associate Professor at GMC Eluru since 2 March 2023.

Her academic profile spans diagnostic cytopathology, hematopathology, and surgical pathology, with a focus on improving diagnostic accuracy and laboratory quality. Her research contributions include fine needle aspiration cytology of soft tissue tumors, clinico-pathological patterns of CNS neoplasms, and evaluation of proliferative indices in tumor pathology. She has also conducted studies on peripheral blood and bone marrow profiles in pancytopenia, contributing to a better understanding of common hematological disorders in tertiary care. In addition, she has participated in education-oriented and quality-improvement initiatives, particularly pre-analytical process training and KAP studies among healthcare students. Through her integrated roles in teaching, diagnostics, and research, she supports academic advancement and clinical training in pathology. ORCID iD: http://orcid.org/0009-0004-8395-4252

Dr. Sasikala Salikanti, Assistant Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India

is an Assistant Professor in the Department of Pathology at Dr. Yellapragada Subbarao Government Medical College, Eluru, Andhra Pradesh, India. She completed her MBBS from Guntur Medical College, Guntur (2008–2013), followed by her compulsory rotating internship in 2013–2014. She obtained her MD in Pathology from the same institution, graduating in 2020. She began her academic and clinical career at Mamata Medical College, Khammam, where she worked from October 2020 to October 2022 as Senior Resident and Assistant Professor. Since October 2022, she has been serving as an Assistant Professor at Dr. YSR Government Medical College, contributing to undergraduate training, diagnostic pathology services, and departmental academic activities.

Her professional interests span histopathology, cytopathology, hematopathology, and improving diagnostic processes in multidisciplinary clinical settings. Dr. Sasikala is actively involved in teaching and diagnostic work and continues to build her academic profile through departmental responsibilities and ongoing scholarly engagement.

Dr. Sandhya Pitla, Assistant Professor, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India

is an Assistant Professor in the Department of Pathology at Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India. She completed her MBBS from Guntur Medical College, Guntur (2004–2009), followed by her MD in Pathology from NRI Medical College, Chinakakani (2013–2016). She began her academic career at Dr. PSIMS & RF, where she served as Assistant Professor from 2017 to 2021 and subsequently as Associate Professor from 2021 to 2023. She later joined the Government Medical College, Eluru, where she has been working as an Assistant Professor since 2023.

Dr. Pitla’s research interests include dermatopathology, infectious disease pathology, and laboratory biomarkers. She has published notable work on laboratory biomarkers predicting COVID-19 disease progression and on histopathological patterns of epithelial, melanocytic, and adnexal skin tumors in tertiary-care settings. Her work emphasizes diagnostic accuracy, clinico-pathological correlations, and evidence-based laboratory practices. With a blend of teaching experience, diagnostic expertise, and research productivity, Dr. Sandhya Pitla continues to contribute to medical education and pathology services in a sustained and meaningful manner.

Dr. Satyanarayana Polisetty, Professor and Head, Department of Pathology, Dr. Yellapragada Subbarao Government Medical College and General Hospital, Eluru, Andhra Pradesh, India

is Professor and Head of the Department of Pathology at Dr. Yellapragada Subbarao Government Medical College, Eluru, Andhra Pradesh, India. He completed his MBBS (1985) and internship (1986) at Rangaraya Medical College, Kakinada, and later obtained his MD in Pathology from the same institution in 2000. He entered the Government Medical Services in 1986 and served across several primary health centres before moving into academic pathology. He joined RMC Kakinada as Assistant Professor in 2001, became Associate Professor at Andhra Medical College, Visakhapatnam, in 2008, and was promoted to Professor and Head at Dr. YSR GMC Eluru in 2023. He has also served as Vice Principal (Academic). With over 25 years in medical education, he has mentored multiple postgraduate dissertations, examined for several universities, and published 18 research papers in reputed journals. His academic interests include surgical pathology, hematopathology, cytopathology, and leadership in medical education.

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