Objective: To review cytological findings and diagnostic challenges in the use of fine needle aspiration in the diagnosis of extramedullary plasmacytoma.

Methods: Five cases of extramedullary plasmacytoma that were initially diagnosed on fine needle aspiration cytology over a period of two years in Sir Ganga Ram Hospital were reviewed.

Results: The cytological findings were similar in all five cases. The smears were cellular and composed of plasmacytoid cells arranged singly and in clusters, with varying pleomorphism, bi- and multinucleation and mitotic figures. Presence of anaplasia, increased plasmablasts, numerous naked nuclei and unusual location of the tumour were some of the challenges faced during the cytological evaluation.

Conclusions: Extramedullary plasmacytoma may occur either as an initial presentation or as a secondary involvement by multiple myeloma. Fine needle aspiration is a reliable technique for its rapid diagnosis.