tive technique, with low complication risks and high diagnostic value in distinguishing neoplastic versus nonneoplastic lesions in many organs. This study was Dina Mody, M.D. 1,2 designed to determine the reliability, areas of diagnostic difficulty, and limitations 1 Cytopathology Laboratory, Baylor College of of FNA in the diagnosis of bone lesions encountered in a university-affiliated Medicine, Houston, Texas.tertiary care hospital. RESULTS. The patients ranged in age from 5 to 94 years, with a male-to-female ratio of 1.25:1. The spine was the most frequently aspirated site (49%), followed by the ilium, sacrum, mandible, ribs, and femur. Three hundred and eighty-five aspirates (86%) were adequate for evaluation, with 215 cases diagnosed cytologically as positive for malignancy, 11 cases as suspicious but not diagnostic of malignancy, and 2 cases as inconclusive. One hundred and fifty-seven cases were interpreted as showing no evidence of malignancy. Metastatic carcinoma was present in 175 of the 215 malignant aspirates, and 67% of these were adenocarcinomas. Forty cases were primary malignant bone neoplasms, including myeloma, lymphoma, Ewing's sarcoma, chondrosarcoma, ameloblastoma, chordoma, neurofibrosarcoma, and unclassified high grade sarcoma. False-negative diagnoses were rendered in ten cases; however, on review, material representative of the bone lesion was not present in six cases. Five cases were correctly diagnosed as malignant but were misclassified with regard to the type of malignancy. arge core needle biopsy cytopathology has been recognized and utilized as a reliable test for the evaluation of bone lesions to distinguish between inflammatory and reactive changes, as well as METHODS. CONCLUSIONS.
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