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Core-needle biopsy performed by the cytopathologist : a technique to complement fine-needle aspiration of soft tissue and bone lesions

Domanski, Henryk A LU ; Åkerman, Måns LU ; Carlén, Birgitta LU ; Engellau, Jacob LU ; Gustafson, Pelle LU ; Jonsson, Kjell LU ; Mertens, Fredrik LU and Rydholm, Anders LU (2005) In Cancer 105(4). p.229-239
Abstract

BACKGROUND: Fine-needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of musculoskeletal lesions; and, in many patients, a definitive diagnosis can be rendered from aspiration smears alone. The main limitation of FNAC of soft tissue and bone neoplasms is in the evaluation of tissue architecture. In addition cytologic specimens are not always adequate for ancillary studies.

METHODS: A consecutive series of 130 patients with soft tissue and bone lesions was examined by core-needle biopsy (CNB) performed by a cytopathologist in conjunction with FNAC. The findings of this combined diagnostic approach were compared with histologic diagnoses made on surgical biopsies and resected specimens from 86 patients.... (More)

BACKGROUND: Fine-needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of musculoskeletal lesions; and, in many patients, a definitive diagnosis can be rendered from aspiration smears alone. The main limitation of FNAC of soft tissue and bone neoplasms is in the evaluation of tissue architecture. In addition cytologic specimens are not always adequate for ancillary studies.

METHODS: A consecutive series of 130 patients with soft tissue and bone lesions was examined by core-needle biopsy (CNB) performed by a cytopathologist in conjunction with FNAC. The findings of this combined diagnostic approach were compared with histologic diagnoses made on surgical biopsies and resected specimens from 86 patients. Adequate follow-up was available in all patients.

RESULTS: FNAC combined with CNB correctly could identify 77 of 78 malignant lesions and 50 of 52 benign lesions. Only seven patients underwent incisional biopsy. The tumor subtype was determined correctly in 30 of 39 patients (77%) and the malignancy grade was determined in 35 of 39 patients (90%) with primary soft tissue and bone sarcomas compared with the biopsy or operative specimens.

CONCLUSIONS: FNAC of musculoskeletal tumors/lesions complemented with CNB combined cytomorphology with tissue architecture and ancillary procedures. In the current study, obtaining FNAC as well as CNB at the same clinic visit and by the cytopathologist made preliminary diagnosis on the day of referral possible. This speeded diagnosis increased the number of correct diagnoses and usually enabled correct subtyping and malignancy grading of sarcomas.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Biopsy, Fine-Needle, Biopsy, Needle, Bone Diseases, Cytodiagnosis, Female, Humans, Lymphoma, Male, Sarcoma, Soft Tissue Neoplasms, Case Reports, Journal Article, Research Support, Non-U.S. Gov't
in
Cancer
volume
105
issue
4
pages
11 pages
publisher
John Wiley and Sons
external identifiers
  • pmid:15918176
  • wos:000231257200007
  • scopus:23844461485
  • pmid:15918176
ISSN
1097-0142
DOI
10.1002/cncr.21154
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Orthopaedics (Lund) (013028000), Oncology, MV (013035000), Pathology, (Lund) (013030000), Diagnostic Radiology, (Lund) (013038000), Division of Clinical Genetics (013022003)
id
c1ea2859-6c2a-40bb-9a59-a1f800669ee6 (old id 229372)
date added to LUP
2016-04-01 12:10:11
date last changed
2021-10-06 03:47:20
@article{c1ea2859-6c2a-40bb-9a59-a1f800669ee6,
  abstract     = {<p>BACKGROUND: Fine-needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of musculoskeletal lesions; and, in many patients, a definitive diagnosis can be rendered from aspiration smears alone. The main limitation of FNAC of soft tissue and bone neoplasms is in the evaluation of tissue architecture. In addition cytologic specimens are not always adequate for ancillary studies.</p><p>METHODS: A consecutive series of 130 patients with soft tissue and bone lesions was examined by core-needle biopsy (CNB) performed by a cytopathologist in conjunction with FNAC. The findings of this combined diagnostic approach were compared with histologic diagnoses made on surgical biopsies and resected specimens from 86 patients. Adequate follow-up was available in all patients.</p><p>RESULTS: FNAC combined with CNB correctly could identify 77 of 78 malignant lesions and 50 of 52 benign lesions. Only seven patients underwent incisional biopsy. The tumor subtype was determined correctly in 30 of 39 patients (77%) and the malignancy grade was determined in 35 of 39 patients (90%) with primary soft tissue and bone sarcomas compared with the biopsy or operative specimens.</p><p>CONCLUSIONS: FNAC of musculoskeletal tumors/lesions complemented with CNB combined cytomorphology with tissue architecture and ancillary procedures. In the current study, obtaining FNAC as well as CNB at the same clinic visit and by the cytopathologist made preliminary diagnosis on the day of referral possible. This speeded diagnosis increased the number of correct diagnoses and usually enabled correct subtyping and malignancy grading of sarcomas.</p>},
  author       = {Domanski, Henryk A and Åkerman, Måns and Carlén, Birgitta and Engellau, Jacob and Gustafson, Pelle and Jonsson, Kjell and Mertens, Fredrik and Rydholm, Anders},
  issn         = {1097-0142},
  language     = {eng},
  month        = {08},
  number       = {4},
  pages        = {229--239},
  publisher    = {John Wiley and Sons},
  series       = {Cancer},
  title        = {Core-needle biopsy performed by the cytopathologist : a technique to complement fine-needle aspiration of soft tissue and bone lesions},
  url          = {http://dx.doi.org/10.1002/cncr.21154},
  doi          = {10.1002/cncr.21154},
  volume       = {105},
  year         = {2005},
}