Fine Needle Aspiration Biopsy in the Evaluation of Tumor-Like Lesions of Bone

Abstract

Results found in 123 cases of tumor-like bone lesions in which sufficient cellular material for diagnostic purposes was obtained by aspiration biopsy with an outer diameter 0.8 mm needle were discussed. The reliability of the cytological evidence was compared with results of definitive pathology after open biopsy or extirpation of the lesion. Twenty-eight of 39 primary benign lesions, 27 of 38 primary malignant lesions and 57 of 73 metastases were correctly diagnosed. These included those where insufficient cellular material was aspirated. The cytological diagnosis was reliable around 90% of the time when sufficient material was available. One false positive and 2 false negative reports of malignancy were found. Fine needle aspiration biopsy with cytological examination is recommended as a standard procedure in orthopedic oncological examination. The diagnostic reliability of the procedure is at least as good as that of other methods, e.g., X-ray, but does not replace open biopsy and histology when mutilating surgery is being considered. Details are given of 8 cases in which cytology was misinterpreted of 123 of 150 cases where there was sufficient cellular material.