Even if a specific type of bone or soft tissue tumor is strongly
suspected based on its location and appearance on imaging studies, the
only way to confirm the identity of the tumor is by pathologic
examination of a piece of tumor tissue (biopsy specimen). This
examination should be done by a pathologist with experience and
proficiency in the diagnosis of musculoskeletal tumors.
A pathologist is a physician with specialty training in
the examination of tissues that have been removed from the body for the
purpose of diagnosing and characterizing disease. Pathologists at
Lankenau Medical Center have a high level of expertise in bone and soft
tissue pathology and use a variety of specialized techniques to confirm
a diagnosis. For bone tumors, pathologists coordinate closely with
radiologists to make a precise diagnosis.
Pathologic assessment of biopsy specimens from bone and soft tissue
Gross (“naked eye”) and microscopic examination.
The pathologist first examines the biopsy specimen in its
entirety (gross examination), as this may provide important
information about the type of tumor and its relationship to
surrounding tissues. Thin slices of the biopsy specimen are then
cut and examined under a microscope to try to identify the
specific cell or tissue type (tumor type).
Immunohistochemistry and genetic testing. At
times, an exact diagnosis may be difficult to confirm using only
gross and microscopic examination. In these cases, examination
using special stains (called immunohistochemistry stains)
can be done to help identify specific characteristics of a
tumor, which may allow for a precise diagnosis. For some tumors,
special tests are used to look for specific genetic
abnormalities that are associated with certain tumor types; if
these abnormalities are found, they help to confirm the
Tumor grading. If a cancerous tumor (sarcoma)
is diagnosed, the pathologist also examines the tumor tissue to
assign a “grade” to it. Tumor grade is based on factors
associated with the risk of metastasis (local and distant spread
of the cancer), including how abnormal the cells look and how
fast the cells are dividing. A high-grade cancer usually grows
and spreads faster than a low-grade cancer. Tumor grade is an
important consideration when planning treatment. Generally, the
higher the tumor grade, the more aggressive the treatment.
Learn about the pathologist’s role in musculoskeletal tumor diagnosis
To schedule an appointment at the Musculoskeletal Tumor Center, call
1.866.CALL.MLH or use the online
appointment request form. Instructions for new patients are
Lankenau Cancer Center
Schedule an appointment with a Lankenau cancer specialist:
For more information, call 1.866.CALL.MLH.