DIAGNOSTIC UTILITY/ROLE OF FINE NEEDLE ASPIRATION IN (DIAGNOSIS) GIANT CELL (LYTIC)LESIONS OF BONE AND ITS CORRELATION WITH HISTOPATHOLOGY

Abstract

Introduction and Aim : Aim  of this study was to  assess the accuracy of Fine Needle aspiration cytology(FNAC)  in the diagnosis of giant cell lesions  (Lytic  Lesions)  of bone .Accurate diagnosis of these lesions is of atmost importance as the treatement modalities are different  for  various bone lesions .FNAC  is accurate, safe, cost-effective .The  Literature  on this topic are limited  in India. So we wanted to study and assess the technique. We also focused on limitations and advantages of FNAc in these lesions. Lastly we compared our results of FNAC with the gold standard Histopatholical samples.

Material and Methods: We took Clinical and Radiological findings into consideration first then we proceeded for FNAC. FNAC was done using 22 -23 Gauge needles along with 10 ml disposable syringe and 20 Gauge needle for deep lesions. Cytology smears were stained by PAP and H&E. 

Result: We studied 105 cases, during period of February, 2015 to September, 2021.Out of 105 cases of lytic (giant cell) lesions of bone we studied, 35 cases were of Inflammatory, 25 cases of Benign tumors, 20 cases of primary malignant bone tumors. Most of the patients belonged to the 11-20 years age group with the age incidence varying with the type of lesion. Out of these 105 Cases 56 were males and 49 were females. The lytic lesions were more common amongst males within the age group of 11-20 years. Diagnostic accuracy in this study was 51 to 100%. Positive and negative predictive value was 99% and 91% respectively. 

Conclusion: Taking the clinical and radiological findings into consideration, benign tumors are more common amongst  all lytic lesions with Giant cell tumor taking first place. Tuberculosis Osteomyelitis is commoner than pyogenic osteomyelitis. Secondaries in the bone are more commonly found than primary malignant tumors.

Keywords- fnac; fine needle aspiration; cytology; giant cell lesion; bone histopathology