Common Errors Made by Pathologists in the Diagnosis of Bone Tumors

Abstract

Pathologists have a great deal of difficulty in diagnosing bone tumors, whether benign or malignant. The classification of bone tumors and clear definitions of the various entities have been well outlined in the World Health Monograph. It is true that bone tumors are rare. Biopsy is often improperly performed; adequate material is not obtained and, most important, the tissue is poorly processed. Before the pathologist even looks at the slides on a patient suspected of having a bone tumor, he should look at the radiographs. It must be remembered that the radiograph is merely a poor reproduction of the gross of the tumor. Its importance cannot be minimized. No pathologist should ever attempt to make a diagnosis of bone tumor before he has seen the X-rays. It is true that many pathologists are not experienced in the interpretation of roentgenograms. They should co-operate with their radiologist and look at the films with him. If a segment of bone is removed or amputation is performed, carefully prepared X-rays of the specimen should be made to allow correlation of these findings with the preoperative radiograms. Only in this fashion can the pathologist and radiologist improve their preoperative diagnosis and show the value and limitation of the method.