Cytodiagnosis of Extra-nasal Rhinosporidiosis: A Study of 16 Cases from Endemic Area

CONTEXT: Extra-nasal rhinosporidiosis is not uncommon in endemic region like India. Clinical presentations of extra-nasal rhinosporidiosis lesion often lead to diagnostic dilemma. Cytology can help in the preoperative diagnosis of such lesions. AIMS: The aims of our study were to find the clinico-pathological presentation of extra-nasal rhinosporidiosis and to evaluate the role of cytology in diagnosing these lesions preoperatively. SETTINGS AND DESIGN: Fine-needle aspiration cytology is often used for preoperative diagnosis of sub-cutaneous lesions of the head and neck region. This retrospective study was designed to include the cytologically diagnosed cases of rhinosporidiosis and to compare with final histopathology of the lesions. MATERIALS AND METHODS: A total of 21 cases of extra-nasal rhinosporidiosis were diagnosed in our study period of 18 months. Cytology was approached in 17 cases and 16 cases were diagnosed as rhinosporidiosis, which were included in the study group. Twelve cases were sampled by fine-needle aspiration and four cases by scrap technique. Histopathological confirmation was possible in all cytologically diagnosed cases. RESULTS: Head and neck region were involved in 15 cases and only one case was on the skin of right upper arm. Orbital region was the most common extra-nasal site of involvement. Most of the cases (13 cases, 81.25%) belonged to the age group of 11-30 years. All cytologicaly diagnosed cases of rhinosporidiosis were concordant with histopathology. Only one false-negative case was cytologically diagnosed as suppurative inflammatory lesion. Sensitivity and specificity of cytology in diagnosis of extra-nasal rhinosporidiosis were 94.11% and 100% respectively. CONCLUSIONS: Extra-nasal rhinosporidiosis is an important differential diagnosis of nodular, polypoid mass of head-neck-face region. Cytology can be used as an important tool in preoperative diagnosis of extra-nasal rhinosporidiosis.