Occasionally I’ll aspirate a tumor that does not produce any identifiable tumor cells, or that only produces blood cells. What is the next step? I remove ALL of these tumors. Why? Because invariably most come back as a connective tissue tumor, with about 50% malignant and requiring further treatment. Connective tissue tumors are tumors of the muscle, nerve, bone, or fascia. They rarely produce enough cells during aspiration but usually produce blood. Therefore anytime I can’t identify a tumor on aspiration it is surgically removed and biopsied.