Lytic bone lesions suspected for metastasis: ultrasonically guided fine-needle aspiration biopsy

Ultrasonically guided fine-needle aspiration biopsy (US-FNAB) was performed in 30 patients with a lytic bone lesions suspected for metastasis detected by conventional radiological examinations. The patients were selected for US-FNAB on the basis of the ability of the ultrasound examination to clearly visualize the lesion. The cytological diagnosis was confirmed at surgery in 3 cases, and at clinical and radiological follow-up after more than 6 months in the remaining cases. The lesions were located mostly in the thoracic skeleton (ribs and sternum) and pelvic bone. We diagnosed malignancy in 26 cases and benign lesions in 2 cases. An inadequate sample was obtained in 1 case, and 1 case yielded a false-negative result. According to these results, we obtained a sensitivity of 93%. We conclude that ultrasonically guided fine-needle aspiration biopsy is a useful technique to obtain a pathological diagnosis in cases of lytic bone lesions that can be visualized with this imaging technique.