A Study of Agreement between Histopathological and Clinico-Radiological Diagnosis of Bone Tumours and Tumour-like Lesions

摘要

Bone lesions are diverse and can develop at any site in the bone. They can be non-neoplastic or benign or malignant neoplasms. These neoplasms are most commonly developed during the first few decades of life, but this is not the thumb rule. Bone lesions differ in their clinical and histopathological features, posing diagnostic challenges.Aim: To analyse the level of agreement between the initial clinicoradiological and the subsequent histopathological diagnosis of bone tumours and tumour-like lesions.Materials and Methods: This prospective study was carried out in the Department of Pathology at Ramaiah Medical College and Hospital, Bengaluru, Karnataka, from May 2009 to April 2011 over a period of two years, including analysis performed over a period of month. Data presentation was done in bivariate tables and to understand association between diagnostic entities kappa statistics was estimated and interpreted.Results: In this study, 64 cases consented to be included for the concurrence study. It was observed that among the total number of cases, males were more frequently affected than females, with a ratio of 2.2:1. The peak age of incidence for bone lesions was found to be the second and third decade of life, accounting for 32.3% (n=30) of all cases. Pain with swelling constituted the most common presenting feature (n=28, 43.8%). Osteogenic (n=17, 25%) and Giant cell (n=17, 25%) tumours were the commonest lesions. Kappa statistical coefficient of 0.749 was observed, showing substantial concurrence between the histopathological and radiological diagnosis.Conclusion: The present study revealed that there was a reliable agreement between clinico-radiological and histopathological diagnosis. Histopathological confirmation of radiological diagnosis should be performed before conclusive treatment.