Accurate diagnosis of musculoskeletal lesions by core needle biopsy.
BACKGROUND
Percutaneous needle biopsy has many advantages over open biopsy in the treatment of neoplasms. However, the accuracy of needle biopsy in the diagnosis of musculoskeletal lesions has not yet been established. Here, we evaluate the accuracy and limitations of the procedure for musculoskeletal lesions.


METHODS
The diagnoses of 163 needle biopsies (bone, 91; soft tissue, 72) performed on 157 consecutive patients using a Jamshidi needle or an Ostycut needle for bone lesions, or a Tru-cut needle for soft tissue lesions were compared with the final diagnoses made by open biopsy and/or a definitive operation.


RESULTS
One hundred forty-three specimens (88%) were determined to be adequate for histological examination. Obtaining undamaged cores from very hard bony lesions or sclerotic cyst walls proved difficult. A pathologist with experience in musculoskeletal lesions was able to differentiate malignant tumors from benign lesions in 97% of the cases (bone, 100%; soft tissue, 94%) and arrive at a specific diagnosis in 88% (bone, 96%; soft tissue, 78%) when adequate cores were obtained. Differentiating a well-differentiated liposarcoma from a benign lipoma and inflammatory lesions from benign tumorous conditions, was difficult. The overall accuracy was 77% (bone, 85%; soft tissue, 68%). There was no morbidity related to the procedure.


CONCLUSIONS
The results indicate that needle biopsy is safe and accurate for diagnosing musculoskeletal lesions.
Mitsuyoshi
Goro
G
Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan.
Naito
Noriko
N
Kawai
Akira
A
Kunisada
Toshiyuki
T
Yoshida
Aki
A
Yanai
Hiyoruki
H
Dendo
Shuichi
S
Yoshino
Tadashi
T
Kanazawa
Susumu
S
Ozaki
Toshifumi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods / Q000592:standards*; D001845:Bone Cysts / Q000473:pathology; D001859:Bone Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008067:Lipoma / Q000473:pathology; D008080:Liposarcoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000473:pathology*; D012516:Osteosarcoma / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed