Fine-needle aspiration cytology for the diagnosis of metastatic melanoma: Systematic review and meta-analysis

Brian J. Hall, Robert L. Schmidt, Rohit R. Sharma, Lester J. Layfield

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


Objectives: To perform a thorough review and meta-analysis of studies that have shown non-image-guided fine-needle aspiration cytology (FNAC) to be highly sensitive and specific for assessing questionable metastatic melanoma to lymph nodes. Methods: MEDLINE and Scopus were searched for potentially relevant articles with a search string including the words "melanoma" and "fine needle." All relevant articles were screened by two authors (B.J.H. and R.L.S.). Full articles were screened for extractable data, and the data was pooled for analysis. Results: Of 978 unique studies found, 10 (5,518 cases) met our inclusion criteria. In a pooled analysis of palpation and ultrasound-guided fine-needle aspirations, the area under the receiver operating characteristic curve was 0.99 (95% confidence interval [CI], 0.99-1.00). The summary estimates for the sensitivity and specificity were 0.97 (95% CI, 0.95- 0.98) and 0.98 (95% CI, 0.98-1.00), respectively. Conclusions: With a sensitivity and specificity of 0.97 and 0.99, the overall diagnostic accuracy of FNAC for metastatic melanoma is quite high, and with a positive and negative likelihood ratio of 58 and 0.03, FNAC for metastatic melanoma should be the first-line option in a patient with a clinically suspected mass and a history of melanoma.

Original languageEnglish (US)
Pages (from-to)635-642
Number of pages8
JournalAmerican journal of clinical pathology
Issue number5
StatePublished - Nov 2013


  • AP cytopathology
  • Fine-needle aspiration
  • Melanoma
  • Meta-analysis
  • Metastatic melanoma
  • Surgical oncology
  • Systematic review

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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