Histopathological spectrum of primary bone tumours and their radiological correlation: A 5-year retrospective study from a tertiary care centre in Northeast India
Manjula Choudhury, Ishita SoodABSTRACT
Background:
Primary bone tumours are rare neoplasms with significant clinical implications owing to their potential for local destruction and metastasis. An accurate diagnosis relies on an integrated approach that combines radiological imaging and histopathological examination.
Aims:
This study aimed to analyse the histopathological spectrum of primary bone tumours, evaluate radiological–histopathological concordance and highlight the diagnostic challenges in Northeast India.
Materials and Methods:
A retrospective study was conducted over 5 years (2020–2024). A total of 113 primary bone tumour specimens, mostly Tru-Cut biopsy specimens and a few excision biopsy specimens, were evaluated. Tumours were classified according to the World Health Organization 2020 classification, and radiological findings (X-ray, computed tomography [CT] and magnetic resonance imaging [MRI]) were compared with histopathological diagnoses to determine concordance rates. Immunohistochemistry and molecular testing were not performed in this study. The data were analysed using statistical methods, including Cohen’s kappa coefficient for agreement.
Results:
Giant cell tumours (31.0%) were the most common primary bone tumours, followed by osteosarcoma (21.2%), osteochondroma (15.0%), small round cell tumours/round cell sarcomas (not further classified; 6.2%), chondrosarcoma (5.3%), aneurysmal bone cyst (4.4%), enchondroma (4.4%) and others (12.4%). The tumours predominantly affected the femur (40.7%) and tibia (25.7%). The mean age was 27.6 years, with a slight male predominance (male: female = 1.02:1). The overall radiological–histopathological concordance was 88.5% (100/113), with an overall Cohen’s kappa value of 0.86. Modality-wise concordance was 86.9% for radiography, 90.0% for CT and 91.7% for MRI.
Conclusion:
An integrated diagnostic approach incorporating advanced imaging and histopathological analysis is crucial for accurate diagnosis and management. Regional epidemiological variations emphasise the need for localised studies to address specific diagnostic challenges and optimise patient outcomes.