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Gouty tophi presenting as multinodular lateral inguinal swelling: A case report

Fine‐needle aspiration cytology (FNAC) is an important diagnostic tool which is replacing biopsy for the diagnosis of subcutaneous nodules. We present a case of 75 years old female with right sided multinodular lateral inguinal swelling since 2 years, without any clinical features of arthritis. FNAC of the lesion revealed negatively birefringent, long needle shaped monosodium urate crystals in the background of amorphous granular debris. Further investigations revealed high serum uric acid levels (9.36 mg/dL) and a confirmed diagnosis of gouty tophus was made. It is important that pathologist should be aware of the cytological features of gouty tophus, particularly in the case with unusual presentation. Gouty nodulosis has never been reported in literature at this site and we are first to report gouty tophus at this unique site.