Patients had an average age of 54 (1 to 92 years),
and 50% were male.
Age was not significantly different between genders and the 7th decade age group had the greater number of biopsies ( Fig. 2 ).
Pelvis and hip lesions predominate (38%),
followed by thigh (14%),
knee and shoulder (10% each) and other locations ( Fig. 3 ).
An osseous sample was taken in 67% of procedures,
using a Jamshidi type needle ( Fig. 4 ),
including thirteen cases (3%) where both bone and soft tissue were collected.
In the remaining cases a core needle biopsy of a soft tissue lesion was performed.
A malignant lesion was diagnosed in 47% of the cases,
mostly metastasis (20%; n=69),
lymphoma (7.8%; n=27) and plasmacytoma/myeloma (5.5%; n=19),
followed by osteosarcoma (3.2%; n=11),
liposarcoma (1.7%; n=6),
chondrosarcoma (1.7%; n=6) and synovial sarcoma (0.9%; n=3),
with other sarcomas accounting for 4.1% (n=14) of the cases ( Fig. 5 ).
We found 40% benign lesions,
including giant cell tumour of the bone (3.5%; n=12),
lipoma (2.6%; n=9) and osteomyelitis (2.0%; n=7),
and also a variety of infrequent or unspecific findings.
In 3% (n=11) a lesion of intermediate malignancy,
like solitary fibrous tumour,
was found.
The analysis of the biopsy specimen was inconclusive in 29 procedures (8.4%).
In 7 biopsies ( Table 1 ) the result was discordant with subsequent definitive diagnosis,
obtained in 58 patients by surgical sample histological analysis; in 4 cases a cartilaginous tumour was present.
Discordant case images are presented ( Fig. 6 to Fig. 12 ).
Forty-four biopsy diagnosis were confirmed by definitive diagnosis.
To illustrate,
confirmed cases of metastasis ( Fig. 13 ),
osteosarcoma ( Fig. 14 ),
liposarcoma ( Fig. 15 ),
chondrosarcoma ( Fig. 16 ),
synovial sarcoma ( Fig. 17 ),
giant cell tumour of the bone ( Fig. 18 ),
solitary fibrous tumour ( Fig. 19 ) and osteomyelitis ( Fig. 20 ) are shown.
Only minor complications were found,
including episodes of tachycardia (0.6%; n=2),
biopsy needle fracture (0.6%; n=2),
pain leading to an interrupted procedure (0.6%; n=2) and delayed bleeding after biopsy (0.3%; n=1).