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    Bone Tumours Evaluation Laboratory Investigations: Biopsy

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    Malueth Angui
    This document discusses the evaluation and diagnosis of bone tumors. Key points include: 1. A full workup includes blood tests, urine tests, and biopsy to determine if lesions are malignant or benign. Biopsy is crucial for determining the correct diagnosis and appropriate treatment. 2. Imaging like x-rays and CT scans can provide information on the location, borders, destruction pattern, and other characteristics of the lesion which help indicate if it is likely benign or malignant. 3. Once diagnosed, tumors are graded and staged surgically to determine the appropriate treatment plan, which may include ablation surgery or radiation therapy. Accurate diagnosis is important as malignant bone tumors have high mortality and morbidity rates.

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    Bone Tumours Evaluation Laboratory Investigations: Biopsy

    Uploaded by

    Malueth Angui
    13 views2 pages
    This document discusses the evaluation and diagnosis of bone tumors. Key points include: 1. A full workup includes blood tests, urine tests, and biopsy to determine if lesions are malignant or benign. Biopsy is crucial for determining the correct diagnosis and appropriate treatment. 2. Imaging like x-rays and CT scans can provide information on the location, borders, destruction pattern, and other characteristics of the lesion which help indicate if it is likely benign or malignant. 3. Once diagnosed, tumors are graded and staged surgically to determine the appropriate treatment plan, which may include ablation surgery or radiation therapy. Accurate diagnosis is important as malignant bone tumors have high mortality and morbidity rates.

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    BONE TUMOURS EVALUATION

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    This document discusses the evaluation and diagnosis of bone tumors. Key points include: 1. A full workup includes blood tests, urine tests, and biopsy to determine if lesions are malignant or benign. Biopsy is crucial for determining the correct diagnosis and appropriate treatment. 2. Imaging like x-rays and CT scans can provide information on the location, borders, destruction pattern, and other characteristics of the lesion which help indicate if it is likely benign or malignant. 3. Once diagnosed, tumors are graded and staged surgically to determine the appropriate treatment plan, which may include ablation surgery or radiation therapy. Accurate diagnosis is important as malignant bone tumors have high mortality and morbidity rates.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    13 views2 pages

    Bone Tumours Evaluation Laboratory Investigations: Biopsy

    Uploaded by

    Malueth Angui
    This document discusses the evaluation and diagnosis of bone tumors. Key points include: 1. A full workup includes blood tests, urine tests, and biopsy to determine if lesions are malignant or benign. Biopsy is crucial for determining the correct diagnosis and appropriate treatment. 2. Imaging like x-rays and CT scans can provide information on the location, borders, destruction pattern, and other characteristics of the lesion which help indicate if it is likely benign or malignant. 3. Once diagnosed, tumors are graded and staged surgically to determine the appropriate treatment plan, which may include ablation surgery or radiation therapy. Accurate diagnosis is important as malignant bone tumors have high mortality and morbidity rates.

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    BONE TUMOURS EVALUATION Laboratory Investigations

    Introduction Blood investigation: R.B.C., Hb, ESR, VDRL, calcium,


    -Tumours forms an important segment of orthopaedic inorganic phosphates and alkaline phosphatase must be
    practice because of the high rate of mortality in the done. In patients above 40. presenting with osteolytic
    malignant bone tumours and the high morbidity after lesions in bone, serum albumin globulin estimation and
    ablational surgery or radiation therapy. serum protein electrophoretic pattern should also be done to
    -The incidence of bone tumours is very low (1 to 1.5% of exclude multiple myeloma. Acid phosphatase is done for
    the total malignancies in the body). prostate carcinoma. Urine examination is done for Bence
    - In clinical practice true neoplasms of bone will have to be Jones protein.
    differentiated from tumour like lesions hamartomas and BIOPSY
    reactive bone lesions, bone cyst(aneurismal or giant cell) Biopsy is the most crucial procedure in the diagnosis of
    ,fibrous dysplasia, Brown tumour lesion in musculo skeletal lesions. The appropriate treatment cannot
    Hyperparathyroidsm be initiated until the correct tissue diagnosis is available.
    - Malignant tumours -Osteosarcomas represented about Prior to the biopsy, all specialists who may ultimately
    56% of these tumors and Ewing’s sarcomas an additional become involved in the patient's care should be consulted as
    34%. to the staus of work up and prebiopsy differential diagnosis.
    Other common- chondrosarcomas, Fibrosarcomas. Types of Biopsy
    -Accurate histological diagnosis is a challenge-biopsy Open Biopsy
    method, mode of preparation and expertise of pathologist. Closed Biopsy
    -Clinical examination to determine malignant tumours Vs Open Biopsy
    Benign tumours and tumour like lesions. Open biopsy has been the conventional method requiring
    an incision under operating room conditions. Select the least
    History differentiated or least mineralised portion of the neoplasm.
    Age Since this is usually the most representative bortion of a
    -Primary bone tumors <20 years malignant lesion. The periphery of any malignant turnour is
    -Painful bone with swelling in.>40 years-secondaries to the the most viable and diagnostic portion of the tumour,
    bone. whereas the central region is often necrotic. A correctly
    For all bone cancer combined, a steady rise in incidence placed biopsy incision must be capable of being excised
    rates occurred with increasing age between ages 5 and 10, enbloc with a malignant tumour when a surgical procedure
    and a steeper rise began at age 11 until age 15 i.e. limb sparing operation is contemplated.
    coinciding with the adolescent growth spurt. The peak
    incidence of bone cancer occur age 15, after which rates Closed Biopsy
    showed a decline
    ¨ Rates did not differ much by sex among younger children,
            A closed biopsy implies that no incison is required and
    but males had higher incidence than females during
    that the tissue specimen is obtained through skin puncture
    adolescence
    by a needle or trephine. It can be done under local
    Plain Radiograph
    anaesthesia and minimises tissue comtamination. Nowadays
    1-The anatomical location of the lesion.
    trocar biopsy is used widely. It cannot be done in
    The tumour can be grouped according to the anatomical
    osteosclerotic bone tumpurs. Mittal (Patiala) has devised the
    location as follows:
    Patiala biopsy needle which is used for closed biopsy.
     Diaphyseal  e.g. Ewing's Sarcoma
     Diaphysio Metaphyseal  : e.g. Chondrosarcoma
     Metaphyseal     e.g. Osteosarcoma CT Assisted Needle Biopsy
     Metaphysio Epiphyseal eg Giant Cell Tumour
    Aneury small Bone Cyst.         Accurate localisation of the tumour in sites like the
     Epiphyseal  e.g. Chondroblastoma spine and pelvis by CT enable closed biopsy of these
    2.  The borders of the tumour lesions. This avoids major surgical procedures for biopsy
    . a. Well defined border, a narrow transitional area and a purposes. This can also be done with image intensifier.
    reactive sclerosis means a benign lesion.
    b. Poorly defined margins indicate a malignant lesion.
    3.  Bone destruction of
    a) geographic pattern (slow growth)
    b) moth eaten pattern (moderate growth)
    c) permeative pattern (rapid growth)
    4.  Matrix formation: New bone formation is another
    parameter to be observed and may vary from woolly masses
    to dense sclerosis.
    5. Periosteal reaction is seen as non continuous and often
    laminated. e.g. Sunray appearance,Onion peel appearance.
    Computerised tomography
    is useful in the management in all stages, from initial
    diagnosis to final management and evaluation of GRADING AND SURGICAL STAGING SYSTEM
    dissemination. -Historically the treatment of malignant bone tumours has

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