Fine needle aspiration cytology of talc granulomatosis in a peripheral lymph node in a case of suspected intravenous drug abuse.

: A fine needle aspiration (FNA) specimen of an epitrochlear lymph node from a 22-year-old suspected intravenous drug abuser was submitted for cytologic examination, which revealed numerous granulomatous tissue fragments, histiocytes, lymphocytes and giant cells. Polarizing microscopy revealed strongly birefringent material of varying shapes and sizes, including anisotropic crystals with the Maltese cross configuration characteristic of starch. A cytologic diagnosis of talc granulomatosis in the lymph node was made. This case emphasizes the value of FNA biopsy in the differentiation of inflammatory versus neoplastic processes; this appears to be the first case of peripheral talc granulomatosis diagnosed by FNA biopsy.