The Role of Fine Needle Aspiration Cytology in the Diagnosis of Bone Tissue Lesions

Abstract

FNAC for the diagnosis of cancer has been used for over a half century to diagnose tumors of almost any organ. In bone however FNAC has not been widely applied because of concerns about its diagnostic accuracy. The present study aimed to determine the value of FNAC in the diagnosis of bone lesions.Between October 2000 and September 2001, FNAC was performed on 60 patients with bone lesions. The material was smeared on glass slides fixed in 95% ethanol stained with Haematoxylin & eosin or Papanicolaous stains. In 54 out of the 60 cases open biopsies were performed and the results were statistically analyzed. Of the 60 patients with bone lesions, the male to female ratio was 1.07:1 The age ranged from 6 to 93 years and the mean age was 37.2 years. Most of the cases were in the second and third decades of life. The cytological diagnoses were malignant in 33 cases (55%) including 25 primary malignant and 8 metastatic tumors. Benign diagnoses were found in 16 cases (26.7), suspicious in 2 cases (3.3%) and unsatisfactory results in 9 cases (15%). Two false positive (3.3%) and two false negative (3.3%) results were encountered.. The sensitivity and specificity were 86.2% and 87.5% respectively; while the overall accuracy was 86.7%. FNAC is a simple, safe and relatively accurate screening procedure for differentiating benign from malignant bone lesions. However specific diagnosis and grading are often difficult to make and therefore it must never be regarded as a substitute for histopathological diagnosis