Fine needle aspiration biopsy of vertebral and paravertebral lesions - Retrospective study of 124 cases

Objective To evaluate the value of image-guided fine needle aspiration biopsy (FNAB) in the diagnosis and management of vertrebral and paravertebral lesions and to review similar studies in the literature. Study Design One hundred twenty-four FNAB cases (13 patients) of vertebral and paravertebral lesions occurring over a 10-year period were retrieved from the archives of the University of Mississippi Medical Center for review and clinico-radiologic correlation. Thirty-four of the cases included a concurrent core needle biopsy sample, 15 cases had subsequent surgical specimens, while 32 cases had previously established malignancy. The age range was 11 days to 91 years (mean, 46 years), with 57 male patients and 56 female. Results One hundred five cases were vertebral lesions, and 19 cases were paravertebral lesions. FNAB diagnoses were malignant in 33.87% of cases, benign in 5.64%, suspicious in 4.03%, infectious/inflammatory and degenerative in 12.91%, unsatisfactory in 16.13% and negative in 27.42%. The overall sensitivity of the procedure was 89.3% and the specificity, 93.8%. The positive predictive value was 95.7% and negative predictive value, 85.2%. Conclusion FNAB is an effective means of establishing a definitive diagnosis of vertebral and paravertebral lesions, allowing appropriate patient management. Cell blocks, core biopsies and ancillary studies are useful adjuncts in rendering the diagnosis.