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Tophi as the Only Manifestation of Gout, Diagnosed on Fine Needle Aspiration Cytology: A Case Report with Review of Literature

Parinitha SS, Sunil Mannual, Vandana UG, and Dinesh US

Gout, a disorder of purine metabolism characterized by deposition of mono-sodium-urate crystals in the joints and soft-tissue commonly presents with peri-articular nodules, also referred to as tophi. Frequently the uric acid levels are near normal at presentation raising doubts about the etiology of the nodules. FNAC (Fine Needle Aspiration Cytology) of the nodules is an efficient method of making a quick diagnosis with characteristic cytological features. Presence of amorphous granular debris should alert the pathologist to search for crystals as it can be easily missed by the untrained eye. We present such a case where the patient presented with tophi as the only manifestation of gout which was confirmed by FNAC.