Role of fine-needle aspiration cytology and core needle biopsy in diagnosing musculoskeletal neoplasms

Abstract

Background:The management of musculoskeletal neoplasms requires an accurate diagnosis, histologic type, and degree of tumor differentiation.Aim:The present study was undertaken to compare the accuracy of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of musculoskeletal tumors and further to compare the results with histopathological examination of surgical specimens. Grading of malignant tumors was also compared on these techniques.Materials and Methods:This prospective study was conducted on 50 patients with musculoskeletal neoplasms. Detailed history, clinical examination, and radiological investigations were undertaken. FNAC followed by CNB were performed in each case. The tumors were categorized as benign and malignant with a definitive histotype diagnosis. For malignant neoplasms, cytologic and histologic gradings were done into three grades. The sensitivity and specificity of FNAC and CNB were compared.Results:Of the 50 cases with musculoskeletal neoplasms, 32 (64%) were bone tumors and 18 (36%) were soft tissue tumors. The sensitivity of FNAC and CNB for categorizing bone tumors into benign and malignant was 94.7%. For soft tissue tumors, FNAC had a sensitivity of 90.9% and CNB had a sensitivity of 100%. The specificity of both the techniques, FNA and CNB for bone and soft tissue tumors was 100%. For malignant bone tumors, cytologic grade was concordant with CNB grade in 72.2% of the cases. Cytologic grade was concordant with the grade on CNB in 81.8% cases for malignant soft tissue neoplasms.Conclusion:FNAC and CNB alleviate the need for an open biopsy in diagnosing and grading musculoskeletal neoplasms, thus facilitating appropriate therapeutic intervention.

Role of Fnac in Bone Lesions, a Cytological and Histological Correlation in a Tertiary Care Center in Central India

“…Non diagnostic cases accounted for 11/92 (11.9%) cases after clinical, cytological, and histological correlation, where as it was seen in 14/92 (15.2%) cases when only aspiration cytology was taken into account. This finding is similar to the failure rates of Handa et al [7] (18.18%) cases, Stromby and Ackerman [8] (17.4%), and Mehrotra et al [19] (10.9%). However, non-diagnostic aspirates accounted for higher number of cases (22.7%) in the study conducted by I kaur [19] and 34.9% of cases in the study conducted by Stromby and Akerman [8] as most of the FNACs were performed by the cytopathologists themselves.…”

“…This finding is similar to the failure rates of Handa et al [7] (18.18%) cases, Stromby and Ackerman [8] (17.4%), and Mehrotra et al [19] (10.9%). However, non-diagnostic aspirates accounted for higher number of cases (22.7%) in the study conducted by I kaur [19] and 34.9% of cases in the study conducted by Stromby and Akerman [8] as most of the FNACs were performed by the cytopathologists themselves. Many authors have the opinion that FNAC has a limited role in diagnosing these types of sclerotic lesions.…”

Diagnostic yield of percutaneous core needle biopsy in suspected soft tissue lesions of extremities

“…There were no false-positive cases in our study, which compares favorably with published reports. 7,12,25 Given the high specificity (100%) and positive predictive value (100%) of the procedure, we recommend decisive initiation of treatment with a positive result.…”

“…Many reports have described the use of percutaneous core needle biopsy (CNB) to diagnose soft tissue lesions. 7,11–14 In most studies, however, only STTs were included, while lesions with clinical and radiological appearances similar to those of STTs, such as infection or tumor-like lesions, were excluded. In addition, to the best of our knowledge, no prior reports have described clinical management changes that were based on CNB findings.…”

The Need to Consider Lymphoma as a Differential Diagnosis in Suspicious Bony Lesions

“…For a certain diagnosis of PBL, a biopsy specimen must undergo histopathological analysis. The procedure of core needle biopsy (CNB) or fine-needle aspiration (FNA) [9,10] is frequently performed to collect tissue samples for histopathological analysis. PBL is characterized histologically by the detection of malignant lymphoid cells in the soft tissues, bone marrow, or trabeculae.…”