Correlation of cytological and histopathological findings in bone lesions: A cross-sectional study

Introduction: Bone lesions represent a diverse group of pathological conditions, including developmental, reactive, infectious, benign, and malignant processes. The age-adjusted incidence rate for all bone and joint cancers is 0.9 per 100,000 persons annually. Globally, the incidence of bone lesions varies based on factors such as geographical location, age, and gender distribution. The aim of the study was to study the sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in bone lesions, comparison of cytological findings to histopathological findings; and identify the accuracy of FNAC in bone lesions.

Material and methods: The study was carried out at a tertiary care centre department of pathology Rohilkhand medical college for the duration of 1 year. A total of 52 bone lesions were analysed. Bone biopsy and FNAC was performed after detailed clinical and radiological examination. The aspirates were air dried, stained by the Leishman Giemsa stain method and examined microscopically. Histology was performed on patients who had subsequent surgical biopsy. These were then correlated with the cytology reports.

Result: Mean age affected was 33 years. Male-female ratio was 1.7:1. Out of total 52 cases of bone tumors and tumor like lesions, maximum was osteogenic tumors followed by chondrogenic tumour. Osteosarcoma (08) and giant cell tumour(10), were the most common primary malignant bone tumour & primary benign bone tumor respectively. The most common bone affected was femur (14; 27.0%), followed by tibia (10; 19.2%).

Sensitivity and specificity of FNAC as a diagnostic modality were 85.71% and 95.83% respectively. The positive predictive value was 96% and the negative predictive value was 85.19%. Cohen kappa value of 0.81 was obtained in this study which showed substantial agreement between the cytological and histopathological impression.

Conclusion: FNAC plays a very crucial role in diagnosing and early intervention and treating any ailment. Bone FNAC also is beneficial for identifying the treatment modality. It should be used on regular basis for bone lesions.