Significance of Diagnosis of Soft Tissue and Bone Tumor Utilizing the Fine Needle Aspiration, Cell Blocks, and Franklin-Silverman Biopsy Needle: A Comparative Study of Three Different Methods

Ha, Kee Yong; Ok, In Young; Moon, Myung Sang; Shim, Sang In

Abstract

In general, soft tissue and bone tumors are diagnosed clinically by physical findings, laboratory data, and X-ray findings with only limited reliability, and a definite diagnosis must be supported by histopathological evidence. For this purpose, open biopsy routinely has been carried out, but there have been many disadvantages and sometimes followed by surgical complications. The present study was undertaken to compare the cytologic findings of soft tissue and bone lesions with the histological findings. The specimen were obtained by fine needle aspiration and Franklin-Silverman needle. For cytodiagnosis Stormby's cell block of aspirates were utilized. For histological diagnosis small tissue fragments obtained by the Franklin-Silvermans cutting needle were used. Then, the diagnostic accuracy of 3 different methods were compared, and the clinical applicability of those methods as adjunctive diagnostic procedures in the diagnosis of the soft tissue and bone tumors were assessed. The results obtained were as follows: l. In 15 out of the 20 cases (75%) in which clinically and roentgenologically the soft tissue and bone tumors were suspected, sufficient material was aspirated to enable detailed cytological diagnosis possible by fine needle aspiration. ln 13 out of the 15 cases, diagnosis could be made by cytologic findings, which was similar to histologic findings of tissue obtained by Franklin-Silverman needle. 2. In 6 out of the 20 cases, sufficient tissue fluid for cell block preparation were obtained from the tumor tissues. In 5 cases, cytologic findings of cell blocks were consistent with that ot the tissue obtained by Silverman needle. But in one case malignancy was susupected by cytodiagnostic method, and definite diagnosis could not be made. Finally the lesion was found to be malignant schwannoma through the histological study of tissue specimen obtained by Franklin-Silverman needle biopsy. 3. In 19 out of the 20 cases, diagnosis could be made by Franklin-Silverman needle biopsy. 4. Diagnostic accuracy of the lesions by clinical and roentgenological method was 75%, which overall diagnostic accuracy of 3 methods were 86.7% in aspiration cytology, 83.3% in cytodiagosis of cell block and 95% of histodiagnosis of tissue specimen obtained by Franklin-Silverman needle. Through this study it is found that cytodiagnostic method of aspirates and histodiagnosis of the small tissue specimen by Franklin-Silverman needle are very useful adjunctive methods in enhancing the diagnostic accuracy of the soft tissue and bone lesion prior to open biopsy trial.