Fine needle aspiration biopsy smears from 19 patients with porphyria cutanea tarda were studied by fluorescence microscopy. Fluorescence was arbitrarily graded from 0 to 4. All patients-those with clinically manifest as well as those with latent disease-showed bright red fluorescence of porphyrin type in the liver cells, though in latent cases the fluorescence commonly was of a low grade. In patients with manifest disease fluorescence of grade 3 or 4 was present. In patients with fluorescence of grades 1 or 2 the uroporphyrin excretion in urine was normal or slightly increased. At higher grades all levels of porphyrin excretion were encountered. Of 22 control subjects, only one showed hepatic fluorescence of a porphyrin character. The control patient with a positive finding was found to have definitely increased urinary uroporphyrin excretion and probably has latent porphyria cutanea tarda. The procedure described should be useful as a screening test for hepatic cutaneous porphyria.
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