The role of fine‐needle aspiration biopsy in the primary diagnosis of mesenchymal lesions

• Published in: Cancer Vol. 90; no. 3; pp. 178 - 185
• Main Authors: Maitra, Anirban, Ashfaq, Raheela, Saboorian, M. Hossein, Lindberg, Guy, Gokaslan, S. Tunc
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 25-06-2000
• Subjects: cytology; fine‐needle aspiration biopsy; mesenchymal; soft tissue
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20000625)90:3<178::AID-CNCR6>3.0.CO;2-S

BACKGROUND
The objective of this study was to determine the utility of fine‐needle aspiration biopsy (FNAB) in the primary diagnosis of mesenchymal lesions. A total of 162 cases with a diagnosis of benign or malignant mesenchymal lesion (excluding lipoma) on FNAB were retrieved from the cytopathology archives for the years 1990–1997.
METHODS
Patients selected for inclusion in this study underwent FNAB as the primary diagnostic modality without a previous tissue diagnosis and had a subsequent surgical procedure for definitive histologic correlation. Seventy‐two patients were selected on the basis of the above criteria.
RESULTS
Cytologic diagnoses were categorized as benign, malignant, or suspicious for malignancy. Among the 72 cases selected, 42 (58%) benign, 18 (25%) malignant, and 12 (16%) suspicious diagnoses were rendered. Of the patients with benign FNAB diagnoses, 39 of 42 (93%) had a benign lesion on histologic follow‐up, and 3 of 42 (7%) had a malignancy. Of the patients with malignant FNAB diagnoses, 17 of 18 (94%) had a malignant lesion and 1 of 17 (6%) proved to be benign. In the subset of suspicious lesions, subsequent histology was benign in 5 of 12 (42%) and malignant in 7 of 12 (58%).
CONCLUSIONS
Based on our study, FNAB has excellent accuracy (88%), sensitivity (89%), and specificity (87%) for classifying a mesenchymal tumor as benign or malignant. FNAB can be a rapid and effective tool for the primary categorization of mesenchymal lesions and provide reliable information to the clinician for triage of patients. Cancer (Cancer Cytopathol) 2000;90:178–85. © 2000 American Cancer Society.
This study demonstrates the value of fine‐needle aspiration for initial workup of mesenchymal lesions. Based on high accuracy and sensitivity, fine‐needle aspiration provides valuable and reliable information to the clinician.