Objective: Percutaneous needle biopsy is an effective and safe technique for obtaining diagnostic material from bone lesions. Study Design: We describe the technical details of fine needle aspiration and core needle biopsy performed in our laboratory of orthopedic pathology. Results: With these procedures, we obtained accurate diagnosis in 83% of 7,375 cases, sent by different orthopedic centers in our country, over a period of 21 years (1986–2007). Conclusion: We describe the percutaneous needle procedure (fine needle aspiration, core needle biopsy), the handling of the materials in detail, the different cytological techniques, as well as the advantages of the procedures and how to avoid its disadvantages. We believe that accurate diagnosis with bone needle biopsy mainly depends on the training of the surgical cytologist and the pathologist, who must integrate all the knowledge on the clinical data, image diagnosis, histological procedures and the experience in the histopathological interpretation of bone lesions.

1.
Coley BL, Sharp GS, Ellis EB: Diagnosis of bone tumors by aspiration. Am J Surg 1931;13:215–224.
2.
Martin HE, Stewart RW: The advantages and limitations of aspiration. Am J Roentgenol Radium Ther 1936;35:345–347.
3.
Ellis F: Needle biopsy in the clinical diagnosis of tumors. Br J Surg 1947;34:240–261.
4.
Schajowicz F: Aspiration biopsy in bone lesions. Cytological and histological techniques. J Bone Joint Surg Am 1955;37-A:465–471.
5.
Schajowicz F, Derqui JC: Puncture biopsy in lesions of the locomotor system. Review of results in 4,050 cases, including 941 vertebral puncture. Cancer 1968;21:531–548.
6.
Schajowicz F, Hokama J: Aspiration (punctures or needle) biopsy in bone lesions; in Grundmann F (ed): Recent Results in Cancer Research. Berlin, Springer, 1976, vol 54.
7.
McCarthy EF: CT-guided needle biopsies of bone and soft tissue tumors: a pathologist’s perspective. Skeletal Radiol 2007;36:181–182.
8.
Springfield SD, Rosenberg A: Biopsy: complicated and risky. J Bone Joint Surg Am 1996;78:639–643.
9.
Kreicbergs A, Bauer H, Brosjo O, Lindholm J, Skoog L, Soderlund V: Cytological diagnosis of bone tumours. J Bone Joint Surg Br 1996;78:258–263.
10.
Valls J, Ottolenghi CE, Schajowicz F: Aspiration biopsy in diagnosis of lesions of vertebral bodies. JAMA 1948;136:376–382.
11.
De Santos LA, Murray JA, Ayala AG: The value of percutaneous needle biopsy in the management of primary bone tumors. Cancer 1979;43:735–744.
12.
Murphy WA, Destouet JM, Gilula LA: Percutaneous skeletal biopsy 1981: a procedure for radiologists – results, review, and recommendations. Radiology 1981;139:545–549.
13.
Ayala AG, Ro JY, Fanning CV, Flores JP, Yasko AW: Core needle biopsy and fine-needle aspiration in the diagnosis of bone and soft-tissue lesions. Hematol Oncol Clin North Am 1995;9:633–651.
14.
Campanacci M, Mercuri M, Gamberini G: Biopsy. Chir Organi Mov 1995;80:113–123.
15.
Hau A, Kim I, Kattapuram S, Hornicek FJ, Rosenberg AE, Gebhardt MC, Mankin HJ: Accuracy of CT-guided biopsies in 139 patients with musculoskeletal lesions. Skeletal Radiol 2002;31:349–353.
16.
Yang YJ, Damron TA: Comparison of needle core biopsy and fine-needle aspiration for diagnostic accuracy in musculoskeletal lesions. Arch Pathol Lab Med 2004;128:750–764.
17.
Handa U, Bal A, Mohan H, Bhardwaj S: Fine needle aspiration cytology in the diagnosis of bone lesions. Cytopathology 2005;16:59–64.
18.
Puri A, Shingade VU, Agarwal MG, Anchan C, Juvekar S, Desai S, Jambhekar NA: CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 2005;35:138–143.
19.
Skrzynsky MC, Biermann JS, Montag A, Simon MA: Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg Am 1996;78:644–649.
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