Skip to main content

Advertisement

SpringerLink
Log in

Fine needle aspiration cytology versus core needle biopsy in the diagnosis of primary bone tumors: a retrospective study

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Background

Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are two outpatient procedures used in the differential diagnosis of a suspected bone tumor. Although open biopsy is a recommended procedure, its invasive nature mandates the search of a minimally invasive procedure for the diagnosis of a bone tumor prior to surgical resection or radio/chemotherapy. Therefore, the aim of this study was to compare the FNAC and CNB regarding their diagnostic accuracy in the diagnosis of primary bone tumor.

Material and methods

All patients suspected of having a bone neoplasm, who underwent FNAC or CNB and subsequent open biopsy or tumor resection during January 2011 to December 2012, were included in the study. Diagnostic accuracy, specific diagnostic rates, specificity, sensitivity, positive predictive value, and negative predictive value (NPV) were calculated for both the procedures, and the proportions were compared by Fischer’s exact test.

Results

A total of 117 patients of primary bone tumor were recruited in this retrospective study. A total sensitivity of 56.6 % and a specificity of 43.4 % were detected for FNAC compared to 78.2 and 95.8 % for CNB which was statistically significant (p values 0.0237 and <0.0001, respectively). The positive predictive value for both techniques was 100 %. The diagnostic accuracy of FNAC was 53 % compared to CNB which was 84.2 % (p value <0.0001). Specific diagnosis could be made in 36 out of 44 (81.8 %) FNAC procedures done, whereas specific diagnosis was made for 58 out of 59 (98.3 %) CNB procedures done (p value 0.0196).

Conclusion

In our study, CNB was found to have superior diagnostic accuracy, sensitivity, specificity, NPV, and specific diagnostic rates when compared to FNAC in diagnosing primary bone tumors. Therefore, CNB emerged as a safe and cost-effective method of diagnosis in bone tumors, although the combined efficiency of both the procedures in our setup needs to be explored further.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Association of Directors of Anatomic and Surgical Pathology (1999) Recommendations for the reporting of soft tissue sarcomas. Am J Clin Pathol 111:594–598

    Google Scholar 

  2. Bennert KW, Abdul-Karim FW (1994) Fine needle aspiration cytology vs. needle core biopsy of soft tissue tumors. A comparison. Acta Cytol 38(3):381–384

    CAS  PubMed  Google Scholar 

  3. Åkerman M (1997) The cytology of soft tissue tumours. Acta Orthop Scand 68(Suppl 273):54–59

    Google Scholar 

  4. Åkerman M, Rydholm A, Persson BM (1985) Aspiration cytology of soft-tissue tumors. The 10-year experience at an orthopedic oncology center. Acta Orthop Scand 56:407–412

    Article  PubMed  Google Scholar 

  5. Willen H, Akerman M, Carlen B (1995) Fine needle aspiration (FNA) in the diagnosis of soft tissue tumors; a review of 22 years experience. Cytopathology 6:236–247

    Article  CAS  PubMed  Google Scholar 

  6. Mitsuyoshi G, Naito N, Kawai A, Kunisada T, Yoshida A, Yanai H, Dendo S, Yoshino T, Kanazawa S, Ozaki T (2006) Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol 94:21–27

    Article  PubMed  Google Scholar 

  7. Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, Toner G, Choong PF (2005) Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg 75:187–191

    Article  PubMed  Google Scholar 

  8. Torriani M, Etchebehere M, Amstalden E (2002) Sonographically guided core needle biopsy of bone and soft tissue tumors. J Ultrasound Med 21:275–281

    PubMed  Google Scholar 

  9. Welker JA, Henshaw RM, Jelinek J, Shmookler BM, Malawer MM (2000) The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 89:2677–2686

    Article  CAS  PubMed  Google Scholar 

  10. Strauss DC, Qureshi YA, Hayes AJ, Thway K, Fisher C, Thomas JM (2010) The role of core needle biopsy in the diagnosis of suspected soft tissue tumours. J Surg Oncol 102:523–529

    Article  CAS  PubMed  Google Scholar 

  11. Sung K-S, Seo S-W, Shon M-S (2009) The diagnostic value of needle biopsy for musculoskeletal lesions. Int Orthop 33(6):1701–1706

    Article  PubMed Central  PubMed  Google Scholar 

  12. Kilpatrick SE, Cappellari JO, Bos GD, Gold SH, Ward WG (2011) Is fine-needle aspiration biopsy a practical alternative to open biopsy for the primary diagnosis of sarcoma? Experience with 140 patients. Am J Clin Pathol 115:59–68

    Article  Google Scholar 

  13. Domanski HA, Åkerman M, Carlen B, Engellau J, Gustafson P, Jonsson K, Mertens F, Rydholm A (2005) Core-needle biopsy performed by the cytopathologist: a technique to complement fine-needle aspiration of soft tissue and bone lesion. Cancer Cytopathology 105(4):229–239

    Article  PubMed  Google Scholar 

  14. McCarthy EF (2007) CT-guided needle biopsies of bone and soft tissue tumors: a pathologist’s perspective. Skelet Radiol 36:181–182

    Article  Google Scholar 

Download references

Conflict of interest

None

Author information

Authors and Affiliations

  1. Department of Orthopaedics, JIPMER, Puducherry, 605006, India

    Deep Sharma, Komuravalli Varun Krishna & D. K. Patro

  2. Department of Biochemistry, JIPMER, Puducherry, 605006, India

    Pooja Dhiman

  3. Department of Pathology, JIPMER, Puducherry, 605006, India

    N. Siddaraju

Authors
  1. Deep Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Komuravalli Varun Krishna
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pooja Dhiman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. K. Patro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N. Siddaraju
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pooja Dhiman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharma, D., Krishna, K.V., Dhiman, P. et al. Fine needle aspiration cytology versus core needle biopsy in the diagnosis of primary bone tumors: a retrospective study. Eur Orthop Traumatol 6, 35–38 (2015). https://doi.org/10.1007/s12570-014-0277-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12570-014-0277-8

Keywords

Search

Navigation