System : Bones & Joints
Introduction
The diagnosis of bone sarcomas is still mainly based on histopathological features and on their comparison with radiological and clinical findings. However, the advent of new technical approaches to tissue study such as immunohistochemistry, molecular biology now allows better characterization of these tumors and hence progress in the understanding of their pathogenesis.
These recent advances provide to the pathologist with new diagnostic markers, thus improving his diagnostic approach to bone tumors.
They also possibly provide the opportunity to reclassify bone tumors following new criteria, or even describe new entities.
Why refer cases for a second opinion ?
Bone sarcomas are very rare but serious disease. Only pathologists that analyze a large number of cases can reach enough morphological expertise. Moreover an optimal technique (optimal decalcification and staining) is necessary since diagnosis is usually done on microscopic examination of hematoxylin-eosin-saffron stained slides.
Besides, Bone pathologists should have some competence on Bone Imaging because most diagnoses are clinicopathological.
More recently some immunohistochemical/molecular markers have been discovered in several tumors leading to more accurate and “integrated” diagnosis.
