Role of fine needle aspiration cytology in bone lesions

Veenu Jain, Tarun Agarwal


Background: FNAC is considered an important procedure in the diagnosis of bone tumors because of its high accuracy. In our study FNA was performed in patients to study the role of FNAC in the diagnosis of bone tumors and to evaluate its usefulness as a diagnostic modality.

Methods: Fine needle aspiration was performed on 54 patients whose age ranged between 5 – 75 years with a male to female ratio 1.84 :1 presented with various bone lesions. The bone lesions included 42 (78%) primary lesions, 5 (9.3%) metastatic deposits and 7 (12. 7%) malignancy of related structures involving the bone.

Results: 47 biopsy specimens were available for cytohistological correlation and cytological findings of 45 cases correlated with histopathology. The overall diagnostic accuracy was 95.92%, with 100% sensitivity and specificity. The predictive values of positive as well as negative test were 100%.

Conclusions: Thus FNA was found to be a safe and an extremely useful, rapid method in the preliminary diagnosis of bone lesions.


FNAC, Histology, Bone tumors, Neoplasm

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Coley BL, Sharp GS, Ellis EB. Diagnosis of bone tumours by aspiration. Am J Surg. 1931;13:215-24.

Stormby N, Akerman M. Cytodiagnosis of bone lesions by means of fine-needle aspiration biopsy. Acta Cytol. 1973;17:166-72.

Ackerman M, Berg NO, Persson BM. Fine needle aspiration biopsy in the evaluation of tumor like lesions of bone. Acta Orthop Scand. 1976;47:129-36.

Thommensen P, Frederiksen P. Fine needle aspiration biopsy of bone lesions. Clinical value. Acta Orthop Scand. 1976;47:137-43.

EL Khoury GV, Ferepka RH, Mickelson MR, Rainville KL, Zaleski MS. Fine needle aspiration of bone. J Bone Joint Surg. 1983;65(A):522-5.

Kumar RV, Rao CR, Hazarika D, Mukherji G, Gouda BM. Aspiration biopsy, cytology of primary bone lesions. Acta Cytol. 1993;37:83-9.

Boomer K, Ramzy I, Mody D. Fine needle aspiration biopsy in the diagnosis & management of bone lesions; A study of 450 cases. Cancer Cytopathol. 1997;81(3):148–56.

Agarwal PK, Goel MM, Chandra T, Agarwal, S. Predictive value of fine needle aspiration Cytology of bone lesions. Acta Cytol. 1997;41(3):659-65.

Jorda M, Rey L, Hanly A, Ganjee, Azar O. Fine needle aspiration cytology of bone: Accuracy & pitfalls of cytodiagnosis. Cancer. 2000;90(1):47–54.

Pai MR, Coimbatore RV, Naik R, Lugade M. Role of fine needle aspiration cytology in the diagnosis of bone tumours. J Cytol. 2002;19(1):33–9.

Wahane RN, Lele VR, Bobhate SK. Fine needle aspiration cytology of bone tumors. Acta Cytol. 2007;51(5):711–20.

Manna AK, Pathak S, Guha D. A cytological and histological study of bone tumors in Paediatric & Adolescent age group. J Cytol. 2005;22(3):118–20.

Feldman PS, Covell JL. Cytodiagnosis of bone & soft tissue lesions by fine needle aspiration. Acta Cytol. 1993;27:558.

James LP, Frable WJ. Fine needle aspiration of bone lesions. Acta Cytol. 1983;27:559-64.

Lay field LJ, Armstrong K, Zaleski S, Eckandt J. Diagnostic accuracy and clinical utility of fine needle aspiration cytology in the diagnosis of clinically primary bone lesions. Diagn Cyto Pathol. 1993;9(2):168-73.

Nnodu OE, Giwa SO, Eyesan SU, Abdul Kareem FB. Fine needle aspiration cytology of bone tumours, the experience from the National Orthopaedic and Lagos University Teaching Hospital, Lagos, Nigeria. Cyto J. 2006;3:16-22.

Kreicbergs A, Bauer HC, Brosjo O, Lindholm J, Skoog L. Soderlund V, Cytological diagnosis of bone tumors. J Bone Joint Surg. 1996;78:258–63.

Jambhekar NA, Moonim MT, Khatib Y. Bone FNAC expectations & limitations : A review. Part-I, J Cytol. 2001;18:1-7.

Khan AR, Mir BA. FNAC Giant cell tumor of bone. A study of 13 cases (part III). JK Practitioner. 2003;10(3):236-8.