Accuracy of fine needle aspiration cytology in the diagnosis of bone lesions with radiological assistance: Experience from the National Cancer Institute,Cairo University,Egypt

Aim

To evaluate the accuracy of fine needle aspiration cytology in the diagnosis of bone lesions with radiological assistance.

Patients and methods

85 cases of FNAC of bone lesions were included. Sixty two procedures were performed by the radiologist and 23 procedures by the histopathologists. The aspirates were immediately fixed in 95% ethanol alcohol for Papanicolaou staining. If there was sufficient material, cell block was prepared. Diagnosis was established in 81 cases (95.3%), classified into 3 categories: (1) positive for malignant cells (57.6%); (2) suspicious for malignant cells (10.6%); and (3) benign, borderline or inflammatory lesions (27.1%). Cytology findings were compared with subsequent available histology.

Results

The overall accuracy was 91%. The 49 cases diagnosed as malignant by cytology were all correct. FNAC could differentiate various giant cell rich lesions and round cell malignancies as Ewing’s sarcoma, myeloma and NHL. Uncommon bone lesions as chordoma and MFH were also correctly diagnosed. Cytological diagnosis of benign and borderline lesions was made in 23 patients. The authors encountered difficulties diagnosing a case of MFH that was reported as osteosarcoma and a case of metastasis that was reported as chondrosarcoma.

Conclusion

FNAC of bone lesions is a simple, safe and accurate diagnostic technique for diagnosis of bone lesions especially when other diagnostic modalities are unavailable.