The Usefulness of Fine Needle Aspiration Cytology of Bone Lesions

골 병변에서 세침흡인 세포검사의 유용성

  • Kim, Bohng-Hee (Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Gong, Gyung-Yub (Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan)
  • 김봉희 (울산의대 서울아산병원 병리과) ;
  • 공경엽 (울산의대 서울아산병원 병리과)
  • Published : 2002.12.30


To determine the usefulness on fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for Inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.


  1. Coley BL, Sharp GS, Ellis GB : Diagnosis of bone tumors by aspiration. Am J Surg 13:213-224, 1931
  2. Pai RR, Raghuveer CV : Extramedullary plasmacytoma diagnosed by fine needle aspiration cytology; A report of Four Cases. Acta Cytol 40:963-966, 1996
  3. Tunc M, Ekinci C : Chondrosarcoma diagnosed by fine needle aspiration cytology. Acta Cytol 40:283-288, 1996
  4. Walaas L, Kindblom LG : Fine needle aspiration biopsy in the preoperative diagnosis of chordoma: A Study of 17 Cases with Application of Electron Microscopic, Histochemical, and Immunocytochemical Examination. Hum Pathol 22:22-28, 1991
  5. Marinsek ZP, Krasovec MU, Lamovec J : Chondroblastoma in fine needle aspirates. Acta Cytol 36:367-370, 1992
  6. Fanning CV, Sneige NS, Carrasco CH, Ayala AG, Murray JA, Raymond AK : Fine needle aspiration cytology of chondroblastoma of bone. Cancer 65:1847-1863, 1990
  7. Walaas L, Kindblom LG : Light and electron microscopic examination of fine-needle aspirates in the preoperative diagnosis of osteogenic tumors: A Study of 21 Osteosarcoma and Two Osteoblastomas. Diagn Cytopathol 6:27-38, 1990
  8. Walaas L, Kindblom LG, Gunterberg B, Bergh P : Light and electron microscopic examination of fine-needle aspirates in the preoperative diagnosis of cartilaginous tumors. Diagn Cytopathol 6:396-408, 1990
  9. Dee S, Meneses M, Ostrowski ML, Murakami M, Horowitz M, Graf W : Pleomorphic('Dedifferentiated') chondrosarcoma; report of a case initially examined by fine needle aspiration biopsy. Acta Cytol 35:467-471, 1991
  10. Vetrani A, Fulciniti F, Boshci R, et al.: Fine needle aspiration biopsy diagnosis of giant cell tumor of bone, an experience with nine cases. Acta Cytol 34:863- 867, 1990
  11. Akhtar M, Ali MA, Sabbah R : Aspiration cytology of ewing's sarcoma, light and electron microscopic correlations. Cancer 56:2051-2060, 1985
  12. Dorfman HD, Weiss SW : Borderline osteoblastic tumors: problems in the differential diagnosis of aggressive osteoblastoma and low grade osteosarcoma. Semin Diagn Pathol 1:215-234, 1984
  13. Mirra JM, Kendrick RA, Kendrick RE : Pseudomalignant osteoblastoma versus arrested osteosarcoma. Cancer 37: 2005-2014, 1976
  14. Ward WG, Kilpatrick S : Fine needle aspiration biopsy of primary bone tumors. Clin Orthop Related Res 373:80-87, 2000
  15. Kabukcuoglu F, Kabukcuoglu Y, Kuzgun U, Evren I : Fine needle aspiration of malignant bone lesions. Acta Cytol 42:875-882, 1998
  16. Agawal PK, Goel MM, Chandra T, Agarwal S : Predictive value of fine needle aspiration cytology of Bone Lesions. Acta Cytol 41:659-665, 1997
  17. Willen H : Fine needle aspiration in the diagnosis of bone tumors. Acta Orthop Scand 68(Suppl 273):47-53, 1997
  18. Civardi G, Livraghi T, Colombo P, Fornari F, Cavanna L, Buscarini L : Lytic bone lesions suspected for metastasis: ultrasonically guided fine needle aspiration biopsy. J Clin Ultrasound 22:307-311, 1994
  19. Kumar RV, Rao CR, Hazarika D, Mukherjee G, Gowda BMG : Aspiration biopsy cytology of primary bone lesions. Acta Cytol 37:83-89, 1993
  20. Targhetta R, Balmes P, Double CM, Mauboussin JM, Bourgeois JM, Pourcelot L : Ultrasonically guided aspiration biopsy in osteolytic bone lesions of the chest wall. Chest 103:1403-1408, 1993
  21. Melkert PW : Fine needle aspiration cytology of bone lesions: Analysis of a three year experience in rural africa. Acta Cytol 34:677-680, 1990
  22. Dollahite HA, Tatum L, Moinuddin SM, Carnesale PG : Aspiration biopsy of primary neoplasms of bone. J Bone Joint Surg 71A:1166-1169, 1989
  23. White VA, Fanning CV, Ayala AG, Raymond AK, Carrasco CH, Murray JA : Osteosarcoma and the role of fine needle aspiration: A study of 51 cases. Cancer 62: 1238-1246, 1988
  24. Koscick RL, Petersilge CA, Makley JT, Abdul-Karim FW : CT-guided fine needle aspiration and needle core biopsy of skeletal lesions; Complementary diagnostic techniques. Acta Cytol 42:697-702, 1998
  25. Schweizer ME, Gannon FH, Doely OM, O'Hara BJ, Juneja V : Percutaneous skeletal aspiration and core biopsy : complementary Techniques. AJR 166:415-418, 1996
  26. Ayala AG, Ro JY, Fanning CV, Flores JP, Yasko AW : Core needle biopsy and fine needle aspiration in the diagnosis of bone and soft tissue lesions. Hematol/Oncol Clinics North Am 9:633-651, 1995
  27. Tikkakoski T, Lahde S, Pauranen J, Apaja-Sarkkinen M : Combined CT-guided biopsy and cytology in diagnosis of bony lesions. Acta Radiol 33:225-229, 1991
  28. 김영실, 김경미, 김진아, 이은정, 이안희, 심상인 : 천골미골부에 발생한 연골양 척삭종의 세침흡인 세포학적 소견: 1예 보고. 대한세포병리학회지 8:199-203, 1997
  29. 하승연, 김인선, 박성혜, 박흠례 : 흉추에서 발생한 척삭종의 세포학적 및 조직학적 소견: 1 예 보고. 대한세포병리학회지 6:199-203, 1995
  30. 연수경, 지미경, 강창석, 김병기, 김선무, 심상인 : 척삭종의 세침흡인 세포학적 소견: 1 예 보고. 대한세포병리학회지 4:133-139, 1993
  31. 송건창, 이광길 : 늑골에 발생한 거대세포종양의 세침흡인 세포학적 소견: 1예 보고. 대한세포병리학회지 4:70-73, 1993
  32. 김규태, 추원석, 정복현 등 : 골전이를 보인 원발성 간암 3 예. 인간과학 15:53-58, 1991
  33. 명나혜, 하창원, 조경자, 장자준, 백구현, 이수용 : 골 거대세포종의 2예 : 세침 천자 세표학적 소견. 대한세포병리학회지 1:93-97, 1990
  34. 심정원, 고일향 : 천골의 세침흡인검사로 진단된 전이성간세포암종. 대한세포병리학회지 1:179-184, 1990