On the utility and limitations of fine-needle aspiration of palpable lesions located in the hand

Role of FNAC in diagnosing lesions of hand and wrist

“…Of these, one case was a metastatic adenocarcinoma (diagnosed later on histopathology) and in 19 cases specific diagnosis could be given on cytology and included basal cell carcinoma, squamous cell carcinoma and melanoma. 23 Among the bone lesions, enchondroma is the most common (more than 90% bone tumors in the hand). Other bone tumors in the hand/ wrist may include osteochondroma, osteoid osteoms, osteoblastoma, and giant cell tumor.…”

“…24 Other lesions encountered for FNAC at these sites (but not seen in our study) reported by other studies include viral infections (herpes and molluscum contagiosum), angioma, glomus tumor, and skin carcinomas. 1,23 The present study describes the cytomorphological spectrum of lesions in the hand and wrist commonly encountered in clinical practice and amenable to diagnosis by FNAC. Most of the cases yielded satisfactory aspirates (86.6%) and in most cases a definitive diagnosis could be given guiding further management/ conservative approach as the case may be.…”

Fine needle aspiration cytology of an acral myxoinflammatory fibroblastic sarcoma: case report with cytological and cytogenetic findings

“…In fact, two patient studies to assess the value FNA cytology in the preoperative diagnosis of tumoral masses in the hands reported no malignant myxoid tumours. 13,14 In these studies, the most common myxoid lesion of the hand was ganglion cyst, while malignant tumours included carcinomas (primary or metastatic), malignant melanoma, dermatofibrosarcoma protuberans 13 and epithelioid sarcomas; 14 other than the latter, no soft tissue tumours showing a preference for acral locations, such as clear cell sarcoma, alveolar rhabdomyosarcoma, synovial sarcoma or even desmoid tumour or infantile fibrosarcoma are reported. Therefore, the main aim is to rule out a ganglion cyst or even an inflammatory or reactive process.…”

Diagnostic utility of fine‐needle aspiration cytology of lesions involving bone

“…In this report, we have confirmed FNA as a valuable, highly sensitive technique (92% sensitivity) for the diagnosis of bone lesions. 35,36 The reluctance to uniformly accept FNA as a valuable technique in the evaluation of bone lesions is partially due to previously published studies which portray FNA as a procedure with relatively limited sensitivity 14,[21][22][23]26 and relatively high nondiagnostic rates, with reported rates as high as 33%. 14,37 While such discouraging data may be the result of varied clinical approaches and processing techniques, other special studies may also be pursued, depending on the on-site impression.…”

“…[18][19][20] The technical challenges of extracting specimens of sufficient cellularity from such mesenchymal lesions is recognized and is a primary factor for the perception that FNA is a procedure of limited value. 14,[21][22][23][24][25][26][27] The spectrum of pathologic entities encountered in these locations has also contributed to resistance to FNA by radiologists and clinicians as a first-line study. Primary mesenchymal neoplasms and reactive mesenchymal conditions may show overlapping cytomorphologic features which make definitive diagnosis by cytomorphology alone problematic.…”