[Value of guided puncture and needle biopsy for the diagnosis of localized bone lesions]

The results of 20 puncture-biopsies and 43 needle-biopsies performed under local anaesthesia and guided towards a localized bone lesion under a fluoroscopic TV screen are reported. Malignancy was confirmed in 31 out of 36 cancerous bone lesions (83%). Metastases were demonstrated in 24/25 cases (96%) and malignant lymphocytic or plasmocytic lesions in 6/6 cases. There were no false-positive results with benign lesions. However, an accurate aetiological diagnosis was supplied by puncture- or needle-biopsy in only 1/5 cases of primary malignant tumour and in 1/6 cases of benign tumour. Guided puncture- or needle-biopsy seems to be particularly useful to distinguish between benign and malignant lesions, notably when bone metastasis is suspected. The technique can then be applied to those cases where puncture-biopsy of the posterior iliac crest is negative or even as first choice procedure if the bone lesion is not readily accessible.