The role of fine-needle aspiration biopsy in the primary diagnosis of mesenchymal lesions - A community hospital-based experience

BACKGROUND. The objective of this study was to determine the utility of fin e-needle aspiration biopsy (FNAB) in the primary diagnosis of mesenchymal l esions. A total of 162 cases with a diagnosis of benign or malignant mesenc hymal lesion (excluding lipoma) on FNAB were retrieved from the cytopatholo gy archives for the years 1990-1997. METHODS. Patients selected for inclusion in this study underwent FNAB as th e primary diagnostic modality without a previous tissue diagnosis and had a subsequent surgical procredure for definitive histologic correlation. Seve nty-two patients were selected on the basis of the above criteria. RESULTS. Cytologic diagnoses were categorized as benign, malignant, or susp icious for malignancy. Among the 72 cases selected, 42 (58%) benign, 18 (25 %) malignant, and 12 (16%) suspicious diagnoses were rendered. Of the patie nts with benign FNAB diagnoses, 39 of 42 (93%) had a benign lesion on histo logic follow-up, and 3 of 42 (7%) had a malignancy. Of the patients with ma lignant FNAB diagnoses; 17 of 18 (94%) had a malignant lesion and 1 of 17 ( 6%) proved to be benign. In the subset of suspicious lesions, subsequent hi stology was benign in 5 of 12 (42%) and malignant in 7 of 12 (58%). CONCLUSIONS, Based on our study, FNAB has excellent accuracy (88%), sensiti vity (89%), and specificity (87%) for classifying a mesenchymal tumor as be nign or malignant. FNAB can be a rapid and effective tool for the primary c ategorization of mesenchymal lesions and provide reliable information to th e clinician for triage of patients. (C) 2000 American Cancer Society.