Usefulness of the cytology in the diagnosis of bone lesions

Abstract

Objective: This study aims to evaluate the interest to systematically combine cytology and histology for all bone specimens.

Methods: We reviewed all the bone biopsies performed in the University Hospital of Brest, France, between January 2000 and March 2008 and for which cytology and histology, obtained at the same time, were available. The interest of cytology and histology, alone and in combination was studied in comparison with the diagnostic made by the practitioner who treated the patient, which was considered the reference.

Results: Seventy patients were included. Among them, 55 had a final diagnosis of cancer. Thirty-nine of them were identified either by cytology or histology: twenty-five were identified by the two techniques, eight only by histology, and six only by cytology. There was no false-positive result, but false-negative results occurred with cytology (n=3) and histology (n=4). The agreement malignancy/benignancy was high (κ=0.84) between cytology and histology when taking into account the only contributive results. It dropped to 0.52 when taking into account all the samples.

Conclusion: Cytology and histology are complementary to each other in diagnosing bone lesion. Combining cytomorphology and tissue architecture increases the accuracy of bone sample and would systematically be performed for each bone biopsy.