Utility of ultrasound-guided core-needle biopsy for osseous masses

Metastatic involvement of superficial lesions, such as the supraclavicular lymph nodes or ribs, is common in advanced lung cancer. Ultrasound-guided core-needle biopsy (US-CNB) is a useful alternative for sampling technique for superficial metastatic sites; however, reports addressing the utility of US-CNB in the diagnostic, especially in osseous masses, workup of lung cancer remain limited. We evaluated the tissue diagnostic yield and complication profile of US-CNB for bone lesions. We retrospectively analyzed eight patients who underwent US-CNB for osseous masses performed by pulmonologists between August 2016 and August 2025. The primary endpoint was the diagnostic yield of US-CNB, and the secondary endpoints included complications and success rates of multiplex genomic panel and programmed death-ligand 1 immunohistochemistry (PD-L1) testing. Definitive histopathological diagnoses were obtained in all patients using US-CNB (8/8). Pathological findings included lung adenocarcinoma (n = 5), renal cell carcinoma (n = 1), undifferentiated osteosarcoma (n = 1), and plasmacytoma (n = 1). No procedure-related complications requiring intervention were observed. Multiplex genomic panel (Oncomine Dx Target Test® and AmoyDx®) and PD-L1 testing were successfully performed in all five cases submitted for these analyses. US-CNB is a safe and minimally invasive diagnostic technique that provides sufficient tissue for histopathological and molecular analyses of osseous masses. US-CNB may serve as a practical alternative to computed tomography-guided or surgical biopsies, particularly in patients with lung cancer with accessible superficial metastases.