Fine needle aspiration of bone lesions: A tertiary care centre experience.

TitleFine needle aspiration of bone lesions: A tertiary care centre experience.
Publication TypeJournal Article
Year of Publication2023
AuthorsSaoud C, Lam H, Gross JM, Ali SZ
JournalCytopathology
Volume34
Issue6
Pagination562-572
Date Published2023 Nov
ISSN1365-2303
KeywordsBiopsy, Fine-Needle, Humans, Middle Aged, Neoplasms, Retrospective Studies, Sensitivity and Specificity, Tertiary Care Centers
Abstract

BACKGROUND: Bone fine needle aspiration (FNA) presents several diagnostic challenges including limited sample material, reduced ability to assess the architecture, and lack of a standardised reporting system. The aim of our study is to present our experience regarding bone FNA.

METHODS: We performed a 6-year retrospective search of our archives to identify all FNA cases of bone lesions. Available data regarding patients' demographics, cytopathology, and surgical pathology were recorded. The FNA cases were then grouped into five categories (atypical, neoplasm-benign, neoplasm of unknown malignant potential, suspicious for malignancy, and malignant) and the risk of malignancy (ROM) was calculated.

RESULTS: A total of 341 FNA cases performed in 337 patients (M = 173, F = 164; mean age = 57.2 years) were identified. The iliac crest was the most commonly biopsied site (n = 134). The adequacy of bone FNA was 77.4%. The sensitivity and specificity regarding the nature of the lesion were 96.5% and 100%, respectively. The overall diagnostic accuracy of bone FNA was 77%. The accuracy of bone FNA for non-metastatic bone lesions including non-neoplastic lesions was 74%, while the diagnostic accuracy of bone FNA for a metastatic disease was 83.5%. The diagnostic accuracy for primary neoplastic lesions was 70%. The frequency (n,%) of cytomorphological categories were as follows: atypical (30, 8.8%); neoplasm-benign (6, 1.8%); neoplasm of unknown malignant potential (18, 5.3%); suspicious for malignancy (4, 1.2%); and malignant (145, 42.5%). The ROM in these categories was respectively as follows: 51.7%, 0%, 46.7%, 100%, and 99.1%.

CONCLUSION: FNA is a sensitive and specific technique for the diagnosis of bone lesions. In most instances, an accurate diagnosis can be achieved if adequate material, ancillary studies, and radiological correlation are available.

DOI10.1111/cyt.13270
Alternate JournalCytopathology
PubMed ID37434498
Related Faculty: 
Hansen Lam, M.D.

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