Patterson K
Children's Hospital and Medical Center, Department of Pathology, University of Washington, Seattle 98105, USA.
Am J Clin Pathol. 1998 Apr;109(4 Suppl 1):S53-66.
Because bone harbors a wide variety of benign and malignant pathologic entities, most of which are uncommon, pathologists feel uneasy when faced with many of these lesions. Accurate diagnoses of these lesions require correlation of the radiologic and clinical findings with the pathologic features. At the time of biopsy, placing a lesion into one of five pathologic groups based on the predominant cell or matrix type present (osteoid, chondroid, giant cell, fibrous, small cell) aids in analyzing the specimen. Current management of malignant bone tumors includes diagnosis on often tiny biopsy samples followed by preoperative chemotherapy and finally limb-sparing resection of the involved bone. Adequate evaluation of these resections requires extensive examination with grading of the tumor necrosis and careful attention to the resection margins.
由于骨中存在各种各样的良性和恶性病理实体，其中大多数并不常见，病理学家在面对许多这类病变时会感到不安。准确诊断这些病变需要将放射学和临床发现与病理特征相关联。在活检时，根据存在的主要细胞或基质类型（骨样、软骨样、巨细胞、纤维、小细胞）将病变归入五个病理组之一，有助于分析标本。目前恶性骨肿瘤的治疗包括对通常很小的活检样本进行诊断，然后进行术前化疗，最后对受累骨进行保肢切除。对这些切除标本进行充分评估需要进行广泛检查，对肿瘤坏死进行分级，并仔细关注切除边缘。
