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
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.