Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Annika Heuer
Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Martin Stangenberg
Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Marc Dreimann
Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Lutz Welker
Institute of Pathology with the Sections Molecular Pathology and Cytopathology, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Carsten Bokemeyer
Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
André Strahl
Department of Trauma and Orthopedic Surgery, Division of Orthopedics, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Anne Marie Asemissen
Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Lennart Viezens
Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
Patients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to determine the feasibility, sensitivity, specificity, and diagnostic certainty of complementary cytological evaluation of spinal lesions suspected of malignancy. In 44 patients, we performed histopathological biopsies and in parallel cytologic preparations from the malignant site. Cytological smears were prepared and stained for May-Grunwald and Giemsa. Bone biopsies were histopathologically analyzed according to the existing standard-of-care practices. In 42 of 44 cases (95%), a cytological sample was successfully obtained. In 40 cases (95.2%, Cohen’s kappa: 0.77), the cytological diagnosis agreed with the histological diagnosis regarding the identification of a malignant lesion. This resulted in a sensitivity of 97% and a specificity of 80% as well as a diagnostic safety of 95%. Cytological analysis in the context of spinal surgery proved sufficient to establish a diagnosis of malignancy or its exclusion, expanding the existing diagnostic spectrum. Furthermore, implementation of this process as a routine clinical diagnostic might shorten the time to diagnosis and improve the treatment of this vulnerable patient group.
