A clinicopathological study of lesions of bone

Abstract

Introduction: Bone tumours are neoplasms originating in the skeletal system that are within or closely related to the bone tissue. A spectrum of pathological bone lesions can present in any form from inflammatory to neoplastic conditions. They account for 0.2% of all tumours in humans. Aims and objectives: To study the clinical and pathological spectrum of lesions of bone. Material and methods: This study was carried out in the Department of Pathology, in a Tertiary health care hospital. It was a hospital based cross sectional study. After obtaining detailed clinical history and examination, biopsies and resected specimen were received in 10% formalin, gross findings were noted and histopathological examination was done. Results: Histopathological evaluation was done in all 106 cases, obtained in a period of 2 years in the tertiary care hospital. In this study, non-neoplastic and benign neoplastic were the commonest bone lesions which accounted for 40.6% each, followed by malignant lesions 15.1% and metastatic lesions 3.7%. The maximum number of bone lesions occurred in second decade of life with a male to female ratio of 1.35:1. The most common presenting feature of all bone lesions was pain. The commonest site of all bone lesions in this study was lower end of femur followed by proximal end of tibia. The most common benign neoplatic neoplasms in this study was giant cell tumour followed by Osteochondroma. Among malignant neoplasm the most common was Osteosarcoma. Epithelial malignancies were the most common to metastasise to bone. Conclusion: Histopathology is the gold standard for the precise diagnosis of the vast number of bone lesions. Since the exact diagnosis of bone tumours is at times difficult, a joint approach integrating clinical, radiological and histopathological findings is necessary to increase accuracy. *Correspondence to: Dnyanada Kokode, Department of Pathology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur-440019, India, E-mail: dr.radhakokode@gmail.com Received: February 06, 2019; Accepted: February 20, 2019; Published: February 25, 2019 Introduction Bone tumours are neoplasms originating in the skeletal system that are within or closely related to the bone tissue [1,2]. A spectrum of pathological bone lesions can present in any form from inflammatory to neoplastic conditions [1,2]. These lesions are diverse in their clinical and morphological features and range in behaviour from innocuous to rapidly fatal [3]. Accurate diagnosis, proper staging and appropriate treatment are thus necessary to ensure maximum patient survival and maintain optimal function of the affected body parts [4]. Primary bone tumours are relatively uncommon lesions [5]. They account for 0.2% of all tumours in humans and some of these tumours display marked interand intranational variations in incidence, site and age distribution [6]. Some relevant demographic features like age, gender and skeletal site are important factors while making a diagnosis [1,7,8]. The lesions predominantly occur in two age groups: adults over 40 years of age and children in the first and second decade of life. Various etiological agents including chemotherapy, radiation, trauma, infections and pre-existing bone lesions have been implicated. Common presentations are progressive pain, swelling, tenderness, restriction in joint mobility and pathological fracture in some of the cases [2,9]. In an Indian study, the most common bone involved was femur [4]. In chronic osteomyelitis and tuberculous lesions; femur and vertebrae respectively are known to be involved commonly. However, some benign processes such as osteomyelitis can mimic malignant tumours, and some malignant lesions such as metastases or myeloma, can mimic benign [3,4]. Aims and objectives To study the clinical and pathological spectrum of lesions of bone. Material and methods This study was carried out in the Department of Pathology, in a Tertiary health care hospital after obtaining Institutional Ethics Committee Clearance. It was a hospital based cross sectional study. Patients presenting with lesions in bone of all age groups and both sexes were included in the research study. Detailed clinical history, radio logical findings and other investigations were noted. FNAC was done wherever possible. All bone biopsies and resected specimens received during a period of 2 years were studied. Biopsies and resected specimen were received in 10% formalin and gross findings were noted. Tissues were processed and stained with routine haematoxylin and eosin stain. Histopathological examination was done under light microscope.