Diagnostic value of image-guided needle aspiration cytology in the assessment of vertebral and intervertebral lesions.

Abstract

The aim of this study was to evaluate the diagnostic value of the noninvasive method of image-guided needle aspiration cytology (NAC) in the assessment of radiologically detected vertebral and intervertebral space-occupying lesions. NAC was performed under computed tomographic (CT) guidance on 70 patients suspected of having a vertebral or intervertebral lesion. Cytologic examination was performed on site after staining smears with the Papanicoloau method. In addition, air-dried smears, fixed smears, filter preparations from needle washings, and cell blocks were studied. The NAC diagnosis was supported by examining cell blocks, which showed the reliability of histologic architecture; further support was obtained with a tissue biopsy in some cases. Additionally, immunoperoxidase and/or histochemical studies were done. Ten cases were diagnosed as inflammatory/degenerative lesions, and in 2 cases a diagnosis of neurofibroma was made. Twelve cases consisted of normal cellular elements, 7 cases were unsatisfactory/inadequate for diagnosis, and 4 cases were suspicious for malignancy. In 32 cases, a variety of metastatic tumors were diagnosed, while in 3 cases, a diagnosis of chordoma was made. Based on our study, we feel that NAC, as a first line of investigation, is not only useful in the diagnosis of space-occupying lesions of vertebral and intervertebral regions, but can also help in deciding on appropriate management. Also, histologic architecture from cell blocks can be correlated with cytology, and such material can be used for histochemical and immunomarker studies.