How to read a pathology report of a bone tumor

The interpretation of a biopsy specimen involving bone is one of the most challenging feats for a pathol-ogist, as it is often difficult to distinguish between benign or reactive lesions and malignant tumors onmicroscopic analysis. Therefore, correlation with the clinical data and imaging is essential and some-times it is only the evolution of certain characteristics over time or information garnered from molecularanalysis that can provide an accurate diagnosis. The pathology report is critical in that it will define sub-sequent patient management; its wording must precisely reflect those elements that are known withcertainty and those that are diagnostic hypotheses. It must be systematic, thorough, and complete andshould not be limited to a simple conclusion. The pathologist must first ensure the completeness andcorrect transcription of the information provided with the specimen, then describe and analyze the his-tology as well as the quality and representative nature of the sample (as they relate to the radiographicfindings and preliminary/final diagnoses), and finally, compare what is seen under the microscope withthe assessment made by the radiologist and/or surgeon.This analysis helps to identify difficult cases requiring further consultation between the radiologist andpathologist.There are multiple reasons for misinterpretation of a pathology report. An important and largelyunderestimated reason is varied interpretations of terms used by the pathologist. Standardized pathol-ogy reports with concise phrases as well as multidisciplinary meetings may limit errors and should beencouraged for optimal diagnostic accuracy