A Comparison of Fine-needle Aspiration, Core Biopsy, and Surgical Biopsy in the Diagnosis of Extremity Soft Tissue Masses

Background Biopsy tissue can be obtained through a fine needle, a wider coring needle, or through an open surgical incision. Though much literature exists regarding the diagnostic yield of these techniques individually, none compare accuracy of diagnosis in the same mass. Questions/purposes We asked...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2010-11, Vol.468 (11), p.2992-3002
Main Authors: Kasraeian, Sina, Allison, Daniel C., Ahlmann, Elke R., Fedenko, Alexander N., Menendez, Lawrence R.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biopsy - methods
Biopsy, Fine-Needle
California
Conservative Orthopedics
Extremities
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Predictive Value of Tests
Prognosis
Prospective Studies
Sensitivity and Specificity
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - surgery
Sports Medicine
Surgery
Surgical Orthopedics
Symposium: Highlights of the ISOLS/MSTS 2009 Meeting
Young Adult
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Summary:Background Biopsy tissue can be obtained through a fine needle, a wider coring needle, or through an open surgical incision. Though much literature exists regarding the diagnostic yield of these techniques individually, none compare accuracy of diagnosis in the same mass. Questions/purposes We asked how the diagnostic accuracy of fine-needle aspiration, core biopsy, and open surgical biopsy compare in regard to identifying malignancy, establishing the exact diagnosis, and guiding the appropriate treatment of soft tissue masses. Patients and Methods We prospectively studied 57 patients with palpable extremity soft tissue masses, performing fine-needle aspiration, followed by core biopsy, followed by surgical biopsy of the same mass. Results Open surgical biopsy was 100% accurate on all accounts. With regard to determining malignancy, fine-needle aspiration and core biopsy had 79.17% and 79.2% sensitivity, 72.7% and 81.8% specificity, 67.9% and 76% positive predictive value, 82.8% and 84.4% negative predictive value, and an overall accuracy of 75.4% and 80.7%, respectively. In regard to determining exact diagnosis, fine-needle aspiration had a 33.3% accuracy and core biopsy had a 45.6% accuracy. With regard to eventual treatment, fine-needle aspiration was 38.6% accurate and core biopsy was 49.1% accurate. Conclusions In soft tissue mass diagnosis, core biopsy is more accurate than fine-needle aspiration on all accounts, and open biopsy is more accurate than both in determining malignancy, establishing the exact diagnosis, and the guiding appropriate treatment. Level of Evidence Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-010-1401-x