Fine-needle aspiration biopsy of bone.

el-Khoury, G Y; Terepka, Raymond H.; Mickelson, Michael R.; Rainville, K L; Zaleski, M. Sue

doi:10.2106/00004623-198365040-00015

Cited by 58 publications

(32 citation statements)

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“…DISCUSSION Most studies evaluating the utility of FNA as a diagnostic procedure for osseous lesions have involved predominantly adult patients, in which secondary (metastatic) lesions are more common. In prior studies, FNA alone is reported to have a diagnostic accuracy ranging from 80% 2,8,9 to close to 90% [10][11][12] with osseous lesions. Accuracy is reported as being greater for bone metastases possibly because of prediagnostic clinical suspicion and characteristic radiologic manifestations.…”

Section: Resultsmentioning

confidence: 99%

“…Despite using such a stringent criterion, our accuracy rate at 83% was comparable to the published literature. 2,3,9,11,12 A recent meta-analysis 14 of both bone and soft tissue tumors suggested that CB was more accurate than FNA, and incisional (open) biopsy appeared to be more accurate than both of those techniques; however, the differences did not reach statistical significance. Our results support the findings of the study by Pohlig et al, 15 which found percutaneous biopsy techniques (fine-needle aspiration and core needle biopsy) yielded slightly superior, but not statistically significant, results compared with OB.…”

Section: Resultsmentioning

confidence: 99%

“…The diagnostic accuracy of this technique significantly increases when paired with fine-needle aspiration (FNA) and on-site evaluation by a pathologist. 1 An FNA is often used in adults to diagnose metastatic osseous lesions, [1][2][3] and FNA and core biopsy (CB), with or without imaging guidance, has been generally accepted for superficial or deep nonosseous lesions in children. [4][5][6][7] However, the use of this technique has been limited for pediatric osseous lesions, which typically have a differential diagnosis that is distinct from that seen in adult patients.…”

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confidence: 99%

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Optimal Diagnostic Yield Achieved With On-site Pathology Evaluation of Fine-Needle Aspiration–Assisted Core Biopsies for Pediatric Osseous Lesions: A Single-Center Experience

Patel

Kinnear

Quintanilla³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Image-guided, fine-needle aspiration-assisted core needle biopsy with an on-site evaluation by a pathologist (FNACBP) of osseous lesions is not a common practice in pediatric institutions.Objectives.-To evaluate the diagnostic adequacy and accuracy of FNACBP for pediatric osseous lesions and to compare the adequacy with procedures that do not use fine-needle aspiration.Design.-Six-year, retrospective review of 144 consecutive children biopsied for osseous lesions with and without fine-needle aspiration assistance.Results.-Pathologic diagnosis was achieved in 79% (57 of 72) of the core biopsies without an on-site evaluation, 78% (32 of 41) of the open biopsies (9 with intraoperative consultation), and 97% (30 of 31) of the FNACBPs as the initial diagnostic procedure. Three FNACBP cases were preceded by nondiagnostic open biopsies. Among 34 lesions sampled by FNACBP, 33 (97%) succeeded with diagnostic tissue, with most (30 of 33; 91%) being neoplasms, including 16 malignant (48%), 13 benign (39%), and 1 indeterminate (3%) lesions. The mostcommon diagnoses were osteosarcoma (9 of 33; 27%) and Langerhans cell histiocytosis (7 of 33; 21%). In cases with follow-up information available, 93% (28 of 30) of the FNACBP-rendered diagnoses were clinically useful, allowing initiation of appropriate therapy. The FNACBP procedure had 100% specificity, sensitivity, and positive predictive value for all 14 malignant lesions, with the sensitivity being 88% in benign lesions. Most FNACBP procedures (32 of 34; 94%) yielded adequate material for ancillary testing. A gradual upward trend was observed for the choice of FNACBP as an initial diagnostic procedure for osseous lesions.Conclusions.-The FNACBP procedure yields sufficient material for diagnosis and ancillary studies in pediatric, osseous lesions and may be considered an initial-diagnostic procedure of choice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Optimal Diagnostic Yield Achieved With On-site Pathology Evaluation of Fine-Needle Aspiration–Assisted Core Biopsies for Pediatric Osseous Lesions: A Single-Center Experience

Patel

Kinnear

Quintanilla³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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“…Inadequancy of material reported by Khoury et al, Agarwal et al, Feldman et al, Kricicberg et al and was between 3-10%. 5,8,13,17 Adequacy of the aspirate plays an important role in deciding this rate, which in turn depends on many factors, such as anatomic localization of the site, characteristics of the tumor, histologic grade of the lesion and adequacy of the clinical and radiologic data. 18 The two inadequate samples obtained in our study were of benign lesions.…”

Section: Resultsmentioning

confidence: 99%

Role of fine needle aspiration cytology in bone lesions

Jain

Agarwal

2016

Int J Res Orthop

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Background: FNAC is considered an important procedure in the diagnosis of bone tumors because of its high accuracy. In our study FNA was performed in patients to study the role of FNAC in the diagnosis of bone tumors and to evaluate its usefulness as a diagnostic modality.Methods: Fine needle aspiration was performed on 54 patients whose age ranged between 5 – 75 years with a male to female ratio 1.84 :1 presented with various bone lesions. The bone lesions included 42 (78%) primary lesions, 5 (9.3%) metastatic deposits and 7 (12. 7%) malignancy of related structures involving the bone.Results: 47 biopsy specimens were available for cytohistological correlation and cytological findings of 45 cases correlated with histopathology. The overall diagnostic accuracy was 95.92%, with 100% sensitivity and specificity. The predictive values of positive as well as negative test were 100%.Conclusions: Thus FNA was found to be a safe and an extremely useful, rapid method in the preliminary diagnosis of bone lesions.

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“…The main criticism against cytology in the diagnosis of bone tumours is based on the anticipated dif culties in obtaining representative cell material because of tumour heterogeneity. 5,6 FNAB would seem to entail an increased risk of erroneous diagnosis compared to open biopsy because of the limited cellular yield from one speci c site within each lesion. Thus, the cell material cannot be considered to re ect the whole of a tumour, since the latter may harbour areas of varying tissue differentiation.…”

Section: Introductionmentioning

confidence: 99%

Representativeness of Radiologically Guided Fine‐NeedleAspiration Biopsy of Bone Lesions

Söderlund

Tani

Domanski

et al. 2002

Sarcoma

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The consistency of the cellular yield as obtained by radiologically guided ne-needle aspiration biopsy (FNAB) was investigated in 29 cases with bone lesions. Aspirates from three different sites of the same lesion were analysed randomly and independently by two cytologists unaware of the clinical and radiological ndings. The series was grouped cytologically into four categories: (1) benign, (2) sarcoma, (3) other malignancy, (4) non-conclusive. A lesion was considered cytologically homogenous, when all three aspirates were identically categorised. Among 29 lesions, 13 and 12, respectively, were assessed as homogeneous by the two cytologists. In the remaining lesions, heterogeneity almost exclusively pertained to the mixture of conclusive and non-conclusive aspirates. An alternative diagnosis was suggested in one case by each cytologist. Comparison of the two cytologists' assessments showed that 21 cases were compliant, i.e., no inter-observer difference in 63 out of 87 aspirates. In the remaining eight cases (24 aspirates), non-compliance was mainly due to differences between the cytologists in the ratio of conclusive versus non-conclusive aspirates. Only the analysis of one and the same aspirate resulted in two different diagnoses. A correct diagnosis was given by the cytologists in 22 and 23 cases, incorrect in two and non-conclusive in ve and four, respectively.Our cytological study of bone lesions, albeit limited, suggests that true tumour heterogeneity is rare. The non-compliance between the two cytologists and the diagnostic dif culties should mainly be attributed to the blind, random approach of the study. The main problem of FNAB pertains to the high rate of non-conclusive aspirates.This, however, does not entail an increased risk of incorrect diagnosis, but rather prompts repeat FNAB.

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Fine-needle aspiration biopsy of bone.

Cited by 58 publications

References 0 publications

Optimal Diagnostic Yield Achieved With On-site Pathology Evaluation of Fine-Needle Aspiration–Assisted Core Biopsies for Pediatric Osseous Lesions: A Single-Center Experience

Optimal Diagnostic Yield Achieved With On-site Pathology Evaluation of Fine-Needle Aspiration–Assisted Core Biopsies for Pediatric Osseous Lesions: A Single-Center Experience

Role of fine needle aspiration cytology in bone lesions

Representativeness of Radiologically Guided Fine‐NeedleAspiration Biopsy of Bone Lesions

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