Role of fine needle aspiration cytology in diagnosis of various giant cell lesions of bone and its Histopathological correlation

Abstract

Introduction: Correct diagnosis is a matter of supreme importance because the treatment varies in different types of musculoskeletal tumors and in conditions simulating these tumors. Because of limited presence of literature for cytological diagnosis of giant cell lesions of the bone, we conducted this study to assess the reliability of Fine needle aspiration cytology in diagnosis of giant cell lesion of the bone and correlating our findings with final histopathological diagnosis. Method: The superficial and deeply located bone lesions were localized with the help of radiographs. For aspiration of superficial lesions 22-23 gauge needles was used along with 10 ml disposable syringe, while for deeply located lesion 20 gauge needles was used. The cytological smears were then stained by May Grunwald Giemsa and Hematoxylin and eosin stain. Result: During the period of one and half years, cytological diagnosis of giant cell lesions was made in 27 cases on FNAC. The mean age of the patient was 21.7 years with male to female ratio of 1.25:1. Maximum number of cases (18/27 cases) was encountered in 11-30 year age group. Tibia was the most common bone involved (12 cases) followed by femur and humerus (5 cases each). On final histopathological evaluation various giant cell lesions consist of 16 cases of Giant cell tumor, 5 cases of aneurysmal bone cyst and 3 cases each of Fibrous dysplasia and Chondromyxoid fibroma. Conclusion: Despite limited literature we wish to recommend fine needle aspiration cytology as initial tool for differentiation of various giant cell lesions especially in conjunction with clinical and radiological findings. Keywords: ABC, Bone tumors, FNAC, Giant cell lesions, GCT