Value and role of percutaneous regional node aspiration cytology in the management of penile carcinoma.

The determination of the status of regional draining lymph nodes is crucial in the prognosis and treatment of penile carcinoma. Tumor staging is inaccurate without histologic examination of the nodes, but the high attendant morbidity rate of lymphadenectomy mandates careful case selection rather than routine prophylactic dissection. Since the penile and pedal lymphography opacifies all lymph nodes involved by penile carcinoma, fine needle aspiration cytology of regional nodes is an innocuous, accurate, easy, and inexpensive diagnostic procedure and alternative to surgical staging in determining the nodal extension of neoplasm. Positive cytology enables rapid, early and even curative lymphadenectomy in patients with clinically negative but microscopically positive nodes. Since radiopaque contrast medium opacifies the nodes for 6-9 months, repeated fine needle aspiration cytology may be used for accurate, careful and regular follow-up examination of patients with penile carcinoma.