TECHNICAL CHALLENGES AND SPECTRUM OF LESIONS IN FINE NEEDLE ASPIRATION CYTOLOGY OF BONE LESIONS

Bone lesions can be approached on the basis of history, radiological examination, fine needle aspiration cytology (FNAC) and excision biopsy of the specimen. Objective: To analyze the technical challenges encountered with the procedure of fine needle aspiration cytology of bone lesions. Methods: A prospective study of fine needle aspiration cytology (FNAC) of bone lesions was done as an outpatient procedure in our institution except for small lesions which were done under radiological guidance. A core needle biopsy was done along with aspiration in all the cases. Aspirates were smeared, few were alcohol fixed and rest air dried and stained with H & E and MGG stains accordingly. The corresponding biopsies obtained were fixed in 10% formalin. Results: The current study is comprised of 25 index cases. The incidence of bone lesions was higher in the age group between 5 to 30 years with a male preponderance. Tibia emerged to be the most common bone to be involved. Sample adequacy was observed in 20 cases. Histopathological correlation was available for 23 cases. Of these, 11 cases were benign and 12 cases were malignant. Conclusions: FNAC is a very useful initial diagnostic modality in bone lesions. The main limitation noted in our study was obtaining an adequate material for cases with intact cortex and small lytic lesions. This study signifies the importance of advent of instruments which will aid in piercing the intact cortex and avoid open biopsy and its complication.