Accuracy, limitations and pitfalls in the diagnosis of soft tissue tumors by fine needle aspiration cytology.

The diagnosis of soft tissue tumors is one of the biggest diagnostic challenges in pathology. In this study, we attempted to measure the accuracy of FNAC in diagnosing soft tissue tumors. All the cases of FNAC with cyto-histological correlation between January 2003 and August 2005 (a total of 72 cases) were collected and sensitivity, specificity, positive and negative predictive values measured. The sensitivity and positive predictive value for differentiating between benign and malignant lesions was 0.8421, while the specificity and negative predictive value was 0.9412 for the same. The main problem was false negatives due to a borderline or low grade spindle cell sarcoma being classified as benign. However, only 18 cases could be typed precisely. Therefore, FNAC has a role in the initial diagnosis of soft tissue sarcomas, but it should be used as a complement rather than a competitor to histopathology.