Soft Tissue and Bone

  • Xiaohua QianEmail author
  • Yaxia Zhang
Part of the Practical Anatomic Pathology book series (PAP)


Preoperative diagnosis of soft tissue and bone tumors using needle biopsy techniques, namely fine needle aspiration (FNA) and core needle biopsy (CNB), has gained wider acceptance in recent years. This is achieved in concert with the maturation of various image-guided needle biopsy techniques, development of molecular genetic diagnostics, and expansion of immunohistochemical biomarkers. FNA, however, as a first-line approach to evaluate soft tissue and bone tumors, remains one of the most challenging and controversial areas in cytopathology. Compared with the CNB, FNA is more suitable for smaller lesions, recurrent and/or metastatic tumors, and lesions with a broad differential diagnosis including carcinomas and lymphomas. Enhanced by rapid on-site evaluation (ROSE), and immediate tissue triage for flow cytometry and/or cytogenetic/molecular studies, FNA offers a valuable and fast diagnostic modality for lesions suspicious for high grade malignancy. This chapter focuses on the practical approaches to this extremely diverse set of benign and malignant neoplasms, emphasizing on pattern recognition, effective triage of biopsy material, and judicious use of ancillary studies. General discussion of the clinical and cytomorphologic features of each entity is beyond the scope of this diagnostic approach–orientated chapter, and the readers are directed to other relevant excellent textbooks.


Soft tissue Bone Sarcoma FNA Molecular Immunohistochemistry Fluorescence in situ hybridization 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Brigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of Pathology and Clinical LaboratoriesHospital for Special SurgeryNew YorkUSA

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