Interobserver reliability in the histopathological diagnosis of cartilaginous tumors in patients with multiple osteochondromas

被引:20
作者
de Andrea, Carlos E. [1 ,2 ]
Kroon, Herman M. [3 ]
Wolterbeek, Ron [4 ]
Romeo, Salvatore [5 ]
Rosenberg, Andrew E. [6 ]
De Young, Barry R. [7 ]
Liegl, Bernadette [8 ]
Inwards, Carrie Y. [9 ]
Hauben, Esther [10 ]
McCarthy, Edward F. [11 ,12 ]
Idoate, Miguel [2 ]
Athanasou, Nicholas A. [13 ]
Jones, Kevin B. [14 ]
Hogendoorn, Pancras C. W. [1 ]
Bovee, Judith V. M. G. [1 ]
机构
[1] Leiden Univ, Dept Pathol, Med Ctr, NL-2300 RC Leiden, Netherlands
[2] Univ Navarra, Dept Pathol, E-31080 Pamplona, Spain
[3] Leiden Univ, Dept Radiol, Med Ctr, NL-2300 RC Leiden, Netherlands
[4] Leiden Univ, Dept Stat, Med Ctr, NL-2300 RC Leiden, Netherlands
[5] Treviso Reg Hosp, Dept Pathol, I-31100 Treviso, Italy
[6] Univ Miami Hosp, Dept Pathol, Miami, FL USA
[7] Univ Iowa, Dept Pathol, Carver Coll Med, Iowa City, IA 52242 USA
[8] Med Univ Graz, Inst Pathol, Graz, Austria
[9] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA
[10] Univ Hosp Leuven, Dept Pathol, Louvain, Belgium
[11] Johns Hopkins Univ Hosp, Dept Pathol & Orthopaed Surg, Baltimore, MD 21287 USA
[12] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
[13] Univ Oxford, Nuffield Orthopaed Ctr, Nuffield Dept Orthopaed Rheumatol & Musculoskelet, Oxford, England
[14] Univ Utah, Dept Orthopaed Surg, Ctr Childrens Canc Res, Huntsman Canc Inst,Primary Childrens Med Ctr, Salt Lake City, UT USA
关键词
bone tumors; peripheral; cartilage tumors; chondrosarcoma; diagnostic criteria; osteochondroma; CHONDROSARCOMA; BONE;
D O I
10.1038/modpathol.2012.78
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The distinction between benign and malignant cartilaginous tumors located peripherally in the bone may be a challenging task in surgical pathology. The aim of this study was to investigate interobserver reliability in histological diagnosis of cartilaginous tumors in the setting of multiple osteochondromas and to evaluate possible histological parameters that could differentiate among osteochondroma, low- and high-grade secondary peripheral chondrosarcoma. Interobserver reliability was assessed by 12 specialized bone-tumor pathologists in a set of 38 cases. Substantial agreement on diagnosis among all the reviewers was observed (intraclass correlation coefficient =0.78). Our study confirmed that mitotic figures and nuclear pleomorphism are hallmarks of high-grade secondary peripheral chondrosarcoma. However, despite the substantial agreement, we demonstrated that histology alone cannot distinguish osteochondroma from low-grade secondary peripheral chondrosarcoma in the setting of multiple osteochondromas, as nodularity, the presence of binucleated cells, irregular calcification, cystic/mucoid changes and necrosis were not helpful to indicate malignant transformation of an osteochondroma. On the other hand, among the concordant cases, the cartilage cap in osteochondroma was significantly less thicker than in low- and high-grade secondary peripheral chondrosarcoma. Therefore, our study showed that a multidisciplinary approach integrating clinical and radiographical features and the size of the cartilaginous cap in combination with a histological assessment are crucial to the diagnosis of cartilaginous tumors. Modern Pathology (2012) 25, 1275-1283; doi:10.1038/modpathol.2012.78; published online 4 May 2012
引用
收藏
页码:1275 / 1283
页数:9
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