Fine needle aspiration of malignant bone lesions

OBJECTIVE: To determine the role of fine needle aspiration (FNA) cytology in the early diagnosis of malignant bone lesions. STUDY DESIGN: Thirty eight bone lesions that were considered malignant clinically and radiographically were evaluated by FNA. The results were compared with the histopathology of the subsequent open biopsies. RESULTS: An accuracy rate of 89.5% was achieved by FNA. Eighty-four percent of the cases were consistent with the clinical and radiographic findings. Chondrosarcoma gave the greatest diagnostic difficulty in the differential diagnosis with other chondroid tumors. Giant cell tumor cases also produced some difficulty when the cytology was hemorrhagic and low in cellularity, displaying-features of other benign bone lesions containing giant cells. Ewing's sarcoma and multiple myeloma could be identified when interpreted with their coexistent clinical findings. The metastatic carcinoma cases were also easy to define, forming another group with a high rate of accuracy. CONCLUSION: FNA plays a valuable role in the initial diagnosis of malignant bone lesions. Cytologic assessment with the clinical and radiologic findings, together with the experience of the cytopathologist, can yield almost the same diagnostic accuracy in the majority of the lesions.