ROLE O F F INE NEEDLE ASPIRATION CYTOLOGY AS AN INITIAL DIAGNOSTIC TOOL I N MUSCULOSKELETAL TUMOURS

Purpose: Inadequate sampling, equivocal cytological features and lack of confirmation with histopathological examination perpetuate long - standing controversy regarding the utility of FNAC in diagnosing skeletal neoplasms. In this study, we tried to conclus ively determine its utility and limitations by analysing the diagnostic concordance between FNAC and open biopsy in each of 216 cases of bone tumours. Materials and Methods: 216 consecutive cases of clinicoradiologically suspected bone tumours were evaluat ed by FNAC and followed up with histopathology of the excised tissue from suspected lesion. The cytological diagnoses were classified as conclusive, doubtful and inadequate and were compared with that of histopathological examination. Results: 97.8% of dia gnoses (n=178) in the conclusive group (n= 182) showed cyto - histological concordance. Sensitivity in diagnosing malignant bone tumours from conclusive smears was 98.78 while specificity was 88.89. Doubtful group (3.24%, n=7) mainly consisted of cartilagino us tumours. The inadequate group (12.5%, n=27) had either scanty cells (37.04%,n=10) or hemorrhagic smear (62.96%,n=17). Conclusion: When the findings are conclusive FNAC provides accurate diagnosis in suspected bone tumours which can be safely relied upo n for planning further management. However, further diagnostic procedures in the form of HPE or cytogenetic studies should be sought in cases of equivocal results or inadequate samping.