title: Predictive value of fine needle aspiration cytology of bone lesions.
abstract: OBJECTIVE
  To determine the predictive value of fine needle aspiration cytology (FNAC) of bone lesions.
  
  
  METHODS
  The study consisted of data retrieval on 200 cases of bone lesions and their cytohistopathologic correlation to assess the diagnostic efficacy of FNAC in these cases, considering histopathology as the gold standard. The diagnostic indices were calculated by a decision matrix comparison.
  
  
  RESULTS
  On cytohistopathologic correlation of 200 cases, 106 (53.0%) were malignant bone tumors (MBT): 97 primary and 9 metastatic; and 76 were benign bone lesions (BBL), 58 neoplastic (29%) and 18 nonneoplastic (9%). The aspirated material was adequate in 181 cases, whereas in 18 cases cytohistopathologic examination revealed no bony lesion. Thus, there were 163 evaluable cases, of which the specific morphologic diagnoses on FNAC were possible in 141 cases (86.5%), with a solitary false positive and 8 false negatives. The percentage of inadequate aspirates was more with BBL (13.2%) than MBT (8.5%). The overall diagnostic accuracy and sensitivity of bone lesions were 95.0%, whereas specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.7%, 99.4% and 69.2%, respectively. The sensitivity of FNAC was better (95.8%) with MBT as compared to BBL (91.7%), whereas specificity and PPV were almost equal (98.8% and 99.2%) in both cases. The NPV in cases of BBL was higher (97.8%) than in MBT (95.2%). These diagnostic indices were calculated excluding the inadequate cases.
  
  
  CONCLUSIONS
  High PPV and NPV indicate the reliability of FNAC for the diagnosis of bone lesions.
authors.affiliation: Department of Pathology and Orthopaedic Surgery, King George's Medical College, Lucknow, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Agarwal
authors.forename: M M
authors.initials: MM
authors.lastname: Goel
authors.forename: T
authors.initials: T
authors.lastname: Chandra
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001847:Bone Diseases / Q000175:diagnosis* / Q000473:pathology; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity