Department of Pathology, Nizams Institute of Medical Sciences, Hyderabad, India.
Department of Pathology, Nizams Institute of Medical Sciences, Hyderabad, India,
Acta Cytol. 2021;65(1):75-87. doi: 10.1159/000511259. Epub 2020 Nov 12.
The aim is to study the utility of fine-needle aspiration cytology (FNAC) in preoperative diagnosis of bone lesions in correlation with radiological and histopathological findings and to determine the spectrum and morphological features of various bone lesions on FNAC.
A total of 275 cases of bone lesions were studied by FNAC over a period of 3 years. 196 procedures were performed by pathologists, and 107 procedures were guided. Cytology findings were correlated with that of histology on cellblocks or on subsequent surgical biopsies. Immunohistochemistry (IHC) was done wherever necessary.
Of the 275 cases, 49 lesions were inflammatory/infectious (granulomatous inflammation-19, nonspecific osteomyelitis-26, and fungal etiology-4), 16 were tumors of undefined neoplastic nature (aneurysmal bone cysts-12, and Langerhans cell histiocytosis-4), 99 lesions were benign (osteoblastoma-6, enchondroma-3, chondroblastoma-14, chondromyxoid fibroma-2, and Giant cell tumor-74), and 111 lesions were malignant (Osteosarcoma-36, chondrosarcoma-7, Ewing's sarcoma-28, lymphomas-4, plasma cell neoplasm-6, adamantinoma of long bone-1, and metastasis-29). Male to female ratio was 2:1, and the age range was between 4 and 84 years. Correlation with histology/cellblock was available in 149 tumors. Metastasis and round cell tumors such as Ewing's sarcoma and lymphoma were differentiated by IHC. The accuracy rate in cytological diagnosis of all bone lesions was 87.9% and for neoplasms was 93%. The discordance in the rest of the cases was due to inadequate cell material, and there were no false positives.
We conclude that FNAC is a simple and accurate preoperative diagnostic technique for assessment of bone tumors.
研究细针抽吸细胞学（FNAC）在术前诊断骨病变中的应用，结合影像学和组织病理学发现，并确定 FNAC 中各种骨病变的谱和形态特征。
在 3 年期间，对 275 例骨病变进行了 FNAC 研究。196 例由病理学家进行，107 例进行引导。细胞学发现与细胞块或随后的外科活检的组织学发现相关。必要时进行免疫组织化学（IHC）。
在 275 例病例中，49 例病变为炎症/感染性（肉芽肿性炎症-19 例，非特异性骨髓炎-26 例，真菌感染-4 例），16 例为未明确肿瘤性质的肿瘤（动脉瘤样骨囊肿-12 例，朗格汉斯细胞组织细胞增生症-4 例），99 例为良性（骨母细胞瘤-6 例，软骨瘤-3 例，软骨母细胞瘤-14 例，软骨粘液样纤维瘤-2 例，巨细胞瘤-74 例），111 例为恶性（骨肉瘤-36 例，软骨肉瘤-7 例，尤文肉瘤-28 例，淋巴瘤-4 例，浆细胞瘤-6 例，长骨造釉细胞瘤-1 例，转移瘤-29 例）。男女比例为 2:1，年龄范围为 4 至 84 岁。在 149 例肿瘤中可与组织学/细胞块相关。IHC 可区分转移瘤和小圆细胞肿瘤，如尤文肉瘤和淋巴瘤。所有骨病变的细胞学诊断准确率为 87.9%，肿瘤的准确率为 93%。其余病例的不一致是由于细胞材料不足，没有假阳性。
我们得出结论，FNAC 是一种简单而准确的术前诊断技术，可用于评估骨肿瘤。
