ABSTRACT

Biopsy of a skeletal lesion, with subsequent histologic examination, is often performed as part of the diagnostic procedure by the traditional triangle of surgeon, radiologist, and surgical pathologist. Needle core biopsy can be used to confirm the clinical and radiological impression or to procure adequate tissue necessary for ancillary studies. This has increasingly translated into the use of percutaneous needle core biopsy (1,2). In essence, the surgical pathology laboratory has the task of extrapolating maximal information from, at times, minimal tissue samples. This information may be used to plan subsequent excisions or the addition of adjuvant therapy, or may result in no further action. The mainstay of pathologic diagnosis remains histologic examination of tissues, utilizing the hematoxylin-eosin stain. Additional special stains, microbiologic cultures, immunohistochemical studies, electron microscopy, flow cytometry, and cytogenetic and molecular diagnostic techniques are also employed when required (3-6). The following chapter briefly covers the histologic and cytologic features of osteomyelitis and selected bone tumors.