IJCRR - 6(14), July, 2014
Pages: 25-31
TECHNICAL CHALLENGES AND SPECTRUM OF LESIONS IN FINE NEEDLE ASPIRATION CYTOLOGY OF BONE LESIONS
Author: C. Nirmala, Priya Patil, Shulba V. Sejekan, A. R. Raghupathi
Category: Healthcare
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Abstract:
Bone lesions can be approached on the basis of history, radiological examination, fine needle aspiration cytology (FNAC) and excision biopsy of the specimen. Objective: To analyze the technical challenges encountered with the procedure of fine needle aspiration cytology of bone lesions. Methods: A prospective study of fine needle aspiration cytology (FNAC) of bone lesions was done as an outpatient procedure in our institution except for small lesions which were done under radiological guidance. A core needle biopsy was done along with aspiration in all the cases. Aspirates were smeared, few were alcohol fixed and rest air dried and stained with H and E and MGG stains accordingly. The corresponding biopsies obtained were fixed in 10% formalin. Results: The current study is comprised of 25 index cases. The incidence of bone lesions was higher in the age group between 5 to 30 years with a male preponderance. Tibia emerged to be the most common bone to be involved. Sample adequacy was observed in 20 cases. Histopathological correlation was available for 23 cases. Of these, 11 cases were benign and 12 cases were malignant. Conclusions: FNAC is a very useful initial diagnostic modality in bone lesions. The main limitation noted in our study was obtaining an adequate material for cases with intact cortex and small lytic lesions. This study signifies the importance of advent of instruments which will aid in piercing the intact cortex and avoid open biopsy and its complication.
Keywords: Bone FNAC, lytic lesions, cortical erosion
Citation:
C. Nirmala, Priya Patil, Shulba V. Sejekan, A. R. Raghupathi. TECHNICAL CHALLENGES AND SPECTRUM OF LESIONS IN FINE NEEDLE ASPIRATION CYTOLOGY OF BONE LESIONS International Journal of Current Research and Review. 6(14), July, 25-31
References:
1. Davies A.M, Sundaram.M, James S.J. Bone Tumors: Epidemiology,Classification, Pathology. Imaging of Bone Tumors and Tumor-Like Lesions: Techniques and ApplicationsEds. Berlin, Germany: Springer, 2009, 1-15.
2. Sherwani R, Akhtar, K, Abrari A et. al. Fine needle aspiration cytology in the management of tumors and tumor like lesions of bone. JK Science 2006. 8(3), 151-6.
3. Coley BL, Sharp GS, Ellis EB: Diagnosis of bone tumors by aspiration. Am J Surg 1931; 13:214-24.
4. Chakrabarti S, Datta A S, Hira M. Critical Evaluation of Fine Needle Aspiration Cytology as a Diagnostic Technique in Bone Tumors and Tumor-like Lesions. Asian Pacific J Cancer Prev 2012; 13: 3031-5.
5. Khalbuss WE, Teot LA, Monaco SE. Diagnostic accuracy and limitations of fine needle aspiration cytology of bone and soft tissue lesions: a review of 1114 cases with cytological-histological correlation. Cancer Cytopathol 2009; 118 (1): 24–32.
6. Kilpatrick SE, Cappellari JO, Bos GD, Gold SH, Ward WG. Is fine-needle aspiration biopsy a practical alternative to open biopsy for the primary diagnosis of sarcoma? Am J Clin Pathol2001; 115:59–68.
7. Jorda M, Rey L, Hanly A, Ganjei-Azar P. Fine-needle aspiration cytology of bone: accuracy and pitfalls of cytodiagnosis. Cancer 2000; 90 (1): 47–54.
8. Dollahite HA, Tatum L, Moinuddin SM, Carnesale PG. Aspiration biopsy of primary neoplasms of bone. J Bone Joint Surg 1989; 71:1166–9.
9. Sahoo M, Sahai K, Nayak VM. Scapulohumeral tuberculosis diagnosed by fine needle aspiration cytology. Acta Cytol 1998; 42:435-6.
10. Kabukcuoglu F, Kabukcuoglu Y, Kuzgun U, Evren I. Fine needle aspiration of malignant bone lesions. Acta Cytol 1998; 42 (4): 875-82.
11. Whit LM, Schweitzer ME, Deely DM. Coaxial Percutaneous Needle Biopsy of Osteolytic Lesions with intact Cortical Bone. Am J Radiol 1996;166:143-4.
12. Moatasim A and Haque A UI.Spectrum of Bone Lesions Diagnosed on Fine Needle Aspiration Cytology. International J Pathol; 2005; 3 (2): 57-64.
13. Agrawal PK, Goyal MM, Chandra T, Agrawal S. Predictive Value of FNAB of bone lesions. Acta Cytol 1997; 41:659-65.
14. Ayala, A G and Zornosa J. Primary Bone Tumors: Percutaneous Needle Biopsy. Radiologic-Pathologic Study of 222 Biopsies. Radiology 1983; 149: 675–9.
15. Wu J S, Jeffrey D, Goldsmith, Perry J, Horwich, Shetty S K, Mary G, Hochman. Bone and Soft-Tissue Lesions: What Factors Affect Diagnostic Yield of Image-guided Core-Needle Biopsy? Radiology 2008; 248:962–70.
16. Nnodu OE, Giwa S, Eyesan SU, Abdulkareem FB. Fine needle aspiration cytology of bone tumors--the experience from the National Orthopaedic and Lagos University Teaching Hospitals, Lagos, Nigeria. Research CytoJournal 2006, 3:16.
17. Elsheikh T, Silverman JF, Wakely PE , Holbrook CT, Joshi V V. “Fine-needle aspiration cytology of Langerhans' cell histiocytosis (eosinophilic granuloma) of bone in children. Diagn Cytopathol 1991; 7 (3): 261–6.
18. Wedin R, Bauer HFC, Skoog L, Söderlund V, Tani E. Cytological diagnosis of skeletal lesions: fine-needle aspiration biopsy in 110 tumors. J Bone Joint Surg 2000;82:673–8.
19. Mehrotra R, Singh M, Singh P A, Mannan R, Ojha V K, Singh P. Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature. Cytojournal 2007; 4: 9–18.
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