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Diagnostic utility of fine-needle aspiration cytology of lesions involving bone.
Diagn Cytopathol. 2017 Jul; 45(7):608-613.DC

Abstract

BACKGROUND

Fine-needle aspiration (FNA) is utilized in the diagnostic work-up of bone lesions in a number of institutions, either in isolation or in conjunction with core biopsy. We report our experience with FNA of bone-based lesions, including comparison of this approach with concurrent core biopsy specimens.

METHODS

Retrospective review over a 5-year period (2011-2015) revealed 233 cases of bone FNAs.

RESULTS

The most commonly encountered diagnosis was malignant neoplasm (160 cases, 68.7%); within this group of malignancies, 103 cases (64.4%) represented metastatic carcinoma. Benign lesions were encountered infrequently (9 cases, 3.9%). While 37 cases (15.9%) revealed "no evidence of malignancy," 12 cases (5.2%) showed atypical findings, 3 cases (1.3%) demonstrated inflammatory conditions, and 12 aspiration biopsies were deemed nondiagnostic (5.2%). In 202 cases, concurrent core biopsies were performed following FNA and rapid on-site evaluation (ROSE). Comparison of the FNA and core biopsy diagnoses among malignant neoplasms revealed 19 diagnostic discrepancies, including 16 cases with a false-negative FNA (7.9% of all FNAs with concurrent core biopsy) and 3 cases with a false-negative core biopsy (1.5% of all cases with corresponding FNA).

CONCLUSION

Our findings indicate that FNA of bone lesions is a useful diagnostic technique with high sensitivity, particularly when the cytologic findings are interpreted in conjunction with the core biopsy and pertinent clinical and radiologic findings. In addition, ROSE followed by open, dynamic communication with the performing radiologist leads to an extremely low rate of inadequate core biopsy specimens, resulting in optimal patient diagnosis and management. Diagn. Cytopathol. 2017;45:608-613. © 2017 Wiley Periodicals, Inc.

Authors+Show Affiliations

Department of Pathology & Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania.Department of Pathology & Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania.Department of Pathology & Laboratory Medicine, Geisinger Medical Laboratories, Danville, Pennsylvania.Department of Radiology, Neuroradiology Division, University of Pennsylvania Health System, Philadelphia, Pennsylvania.Department of Radiology, Musculoskeletal Radiology Division, University of Pennsylvania Health System, Philadelphia, Pennsylvania.Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28470965

Citation

Yu, Gordon H., et al. "Diagnostic Utility of Fine-needle Aspiration Cytology of Lesions Involving Bone." Diagnostic Cytopathology, vol. 45, no. 7, 2017, pp. 608-613.
Yu GH, Maisel J, Frank R, et al. Diagnostic utility of fine-needle aspiration cytology of lesions involving bone. Diagn Cytopathol. 2017;45(7):608-613.
Yu, G. H., Maisel, J., Frank, R., Pukenas, B. A., Sebro, R., & Weber, K. (2017). Diagnostic utility of fine-needle aspiration cytology of lesions involving bone. Diagnostic Cytopathology, 45(7), 608-613. https://doi.org/10.1002/dc.23735
Yu GH, et al. Diagnostic Utility of Fine-needle Aspiration Cytology of Lesions Involving Bone. Diagn Cytopathol. 2017;45(7):608-613. PubMed PMID: 28470965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic utility of fine-needle aspiration cytology of lesions involving bone. AU - Yu,Gordon H, AU - Maisel,Julia, AU - Frank,Renee, AU - Pukenas,Bryan A, AU - Sebro,Ronnie, AU - Weber,Kristy, Y1 - 2017/05/03/ PY - 2017/02/15/received PY - 2017/03/29/revised PY - 2017/04/06/accepted PY - 2017/5/5/pubmed PY - 2018/3/16/medline PY - 2017/5/5/entrez KW - ROSE KW - bone KW - cytology KW - fine-needle aspiration SP - 608 EP - 613 JF - Diagnostic cytopathology JO - Diagn Cytopathol VL - 45 IS - 7 N2 - BACKGROUND: Fine-needle aspiration (FNA) is utilized in the diagnostic work-up of bone lesions in a number of institutions, either in isolation or in conjunction with core biopsy. We report our experience with FNA of bone-based lesions, including comparison of this approach with concurrent core biopsy specimens. METHODS: Retrospective review over a 5-year period (2011-2015) revealed 233 cases of bone FNAs. RESULTS: The most commonly encountered diagnosis was malignant neoplasm (160 cases, 68.7%); within this group of malignancies, 103 cases (64.4%) represented metastatic carcinoma. Benign lesions were encountered infrequently (9 cases, 3.9%). While 37 cases (15.9%) revealed "no evidence of malignancy," 12 cases (5.2%) showed atypical findings, 3 cases (1.3%) demonstrated inflammatory conditions, and 12 aspiration biopsies were deemed nondiagnostic (5.2%). In 202 cases, concurrent core biopsies were performed following FNA and rapid on-site evaluation (ROSE). Comparison of the FNA and core biopsy diagnoses among malignant neoplasms revealed 19 diagnostic discrepancies, including 16 cases with a false-negative FNA (7.9% of all FNAs with concurrent core biopsy) and 3 cases with a false-negative core biopsy (1.5% of all cases with corresponding FNA). CONCLUSION: Our findings indicate that FNA of bone lesions is a useful diagnostic technique with high sensitivity, particularly when the cytologic findings are interpreted in conjunction with the core biopsy and pertinent clinical and radiologic findings. In addition, ROSE followed by open, dynamic communication with the performing radiologist leads to an extremely low rate of inadequate core biopsy specimens, resulting in optimal patient diagnosis and management. Diagn. Cytopathol. 2017;45:608-613. © 2017 Wiley Periodicals, Inc. SN - 1097-0339 UR - https://www.unboundmedicine.com/medline/citation/28470965/Diagnostic_utility_of_fine_needle_aspiration_cytology_of_lesions_involving_bone_ L2 - https://doi.org/10.1002/dc.23735 DB - PRIME DP - Unbound Medicine ER -