Kilpatrick S E, Ward W G, Bos G D, Chauvenet A R, Gold S H
Department of Pathology & Laboratory Medicine, University of North Carolina, CB #7525, Brinkhous-Bullitt Building, Chapel Hill, NC 27599-7525, USA.
Pediatr Pathol Mol Med. 2001 May-Jun;20(3):175-87.
We retrospectively reviewed our experience with fine needle aspiration biopsy (FNAB) in the diagnosis and management of skeletal osteosarcoma. The bi-institutional study sample involved 30 consecutive aspirates from 29 patients (28 primary tumors, 1 pulmonary metastasis, 1 local recurrence). There were 17 children and 12 adults. Two aspirates were unsatisfactory for diagnosis. Of the adequate primary osteosarcoma cases analyzed by FNAB, 24 of 26 were diagnosed as osteosarcoma. All pediatric cases were correctly interpreted as osteosarcoma and treated appropriately. There were 2 incomplete diagnoses. A secondary osteosarcoma arising within an otherwise clinically, radiologically, and histologically typical giant cell tumor (malignant giant cell tumor) was not diagnosed preoperatively on FNAB due to nonrepresentative sampling. Chronologically, the first patient with osteosarcoma analyzed by FNAB was diagnosed simply as "spindle cell neoplasm." No complications resulted from the procedure. With adequate clinical and radiologic correlation, FNAB represents a technically, easily performed, cost-effective, and accurate procedure for establishing the diagnosis of skeletal osteosarcoma. Immediate interpretation of aspirated material allows for therapy planning and oncologic consultation at the initial clinic visit.
我们回顾性分析了细针穿刺活检（FNAB）在骨骼骨肉瘤诊断和治疗中的应用经验。这项双机构研究样本包括来自29例患者的30次连续穿刺（28例原发性肿瘤，1例肺转移瘤，1例局部复发）。其中有17名儿童和12名成人。有2次穿刺结果无法用于诊断。在通过FNAB分析的足够数量的原发性骨肉瘤病例中，26例中有24例被诊断为骨肉瘤。所有儿童病例均被正确诊断为骨肉瘤并得到适当治疗。有2例诊断不完整。在一个临床、放射学和组织学上均典型的骨巨细胞瘤（恶性骨巨细胞瘤）中发生的继发性骨肉瘤，由于采样不具代表性，术前FNAB未诊断出来。按时间顺序，首例通过FNAB分析的骨肉瘤患者仅被诊断为“梭形细胞瘤”。该操作未导致任何并发症。结合充分的临床和放射学检查，FNAB是一种技术上易于操作、经济高效且准确的用于诊断骨骼骨肉瘤的方法。对穿刺样本的即时解读有助于在初次门诊就诊时进行治疗规划和肿瘤学会诊。
