Tumors and Tumor-Like Lesions of Bone: For Surgical Pathologists, Orthopedic Surgeons and Radiologists

994 Pages·2015·0.95 MB·English

by  Eduardo Santini-Araujo

Eduardo Santini-Araujo
Ricardo K. Kalil
Franco Bertoni
Yong-Koo Park
Editors
Tumors and Tumor-Like
Lesions of Bone
For Surgical Pathologists,
Orthopedic Surgeons and
Radiologists
123
Tumors and Tumor-Like Lesions of Bone

Eduardo Santini-Araujo (cid:129) Ricardo K. Kalil
Franco Bertoni (cid:129) Yong-Koo P ark
Editors
Tumors and Tumor-Like
Lesions of Bone
For Surgical Pathologists,
Orthopedic Surgeons and Radiologists
Editors
Eduardo Santini-Araujo Franco Bertoni
Laboratory of Orthopaedic Pathology Villa Erbosa Hospital
Buenos Aires , Argentina University of Bologna
Bologna , Italy
Ricardo K. Kalil
Laboratory of Orthopaedic Pathology Yong-Koo Park
Buenos Aires , Argentina Department of Pathology
Kyung Hee University Hospital
Seoul , Korea, Republic of (South Korea)
ISBN 978-1-4471-6577-4 ISBN 978-1-4471-6578-1 (eBook)
DOI 10.1007/978-1-4471-6578-1
Library of Congress Control Number: 2015939586
Springer London Heidelberg New York Dordrecht
© Springer-Verlag London 2015
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To our mentors
F ritz Schajowicz and David Dahlin, two giants of orthopedic pathology, stand
behind us all.
K Krishnan Unni, whose experience, knowledge, charisma, and leadership
infl uenced all of us, being tireless and obstinate in his long-lasting support
and incentive through several years.
To them, we would like to add those people who had a high infl uence in our
choices and development in pathology, especially R L Cabrini.
Eduardo Santini-Araujo, Ricardo K. Kalil, Franco Bertoni, Yong-Koo Park
To our families
E Santini-Araujo
Wife Romina and sons and daughters, Maria Gala, Martina, Julian, Pedro
Ferreol, and Margarita
R K Kalil
Wife Angela and daughter, sons, and stepsons, Luciana, Sergio, Marcelo,
Marcio, and Mateus
F Bertoni
My beloved family
Y-K Park
My parents, wife Dan-Young, son Byung-Chul, and daughter Ko-Un
To them, our endless love.

Foreword
T he present book on bone tumors and related lesions represents the continuity of a “classic” on
bone tumors by Fritz Schajowicz, one of the most outstanding bone pathologists of all times.
The last edition by Springer-Verlag was published over 20 years ago (H istopathological Typing
of Bone Tumors , 1993) and has been for many years a very useful tool for diagnostic histopa-
thologists all over the world.
T his new book maintains the philosophy of its predecessor but is adapted to the new chal-
lenges in the clinical and histological diagnosis of these infrequent tumors providing insights
into therapeutic approaches and their prognostic outcome.
I n recent years, the clinical approach to bone tumors has been innovated, thanks to the new
diagnostic imaging techniques that complement conventional radiology with CT scan, PET,
and MR, alone or in combination, thanks to which the diagnostic identifi cation of each tumor
entity is much more precise. Also the microscopic phenotyping of tumors and tumor-like
lesions is more effi cient based upon the use of fi ne-needle aspiration cytology, a technique that
requires a profound knowledge of tissue at the histological level and a good understanding of
bone tumor biology. Moreover, histopathology has been enhanced by new methodological
techniques such as electron microscopy and immunohistochemistry, offering the surgical
pathologist unforeseen possibilities for more accurate differential diagnosis of borderline
lesions or doubtful histological tumor types.
N evertheless, the handling of bone tumors still requires a high degree of specialization for
all those involved in this pathology, as well as demanding cooperation between all
specialists.
Bone tumors are not exclusively age based nor particularly anatomically related; thus, pedi-
atric and adult orthopedists are frequently involved in simultaneous consultations, which is
also the case for radiologists and oncologists. This affects the surgical pathologist who needs
highly specifi c training in the fi eld and a case-by-case analysis of each patient in close coop-
eration with their clinical colleagues. Precisely one of the major aims of this book is to cover
this necessity, providing the informative doctrine needed for this end.
Today everyone is pressed for time and, when trying to acquire new knowledge on a fi eld or
looking for a precise diagnosis, needs to fi nd clearly explained concepts in a short, readable,
informative format. This guideline has been followed by each author, thus providing a clear
structure to each chapter. Long academic case discussions and details on etiopathological anal-
ysis have been avoided, compiling brief information on the most update available
publications.
O f course no book today can cover all the available literature on a given fi eld or for a par-
ticular tumor type, but should contain, as in this new book on bone tumors, the most up-to-date
data to facilitate the best practical clinical handling of the patient’s pathology.
T he present book aims to cover all these objectives, approaching the diagnosis of bone
tumors in a dynamic form and placing the histopathologist at the center of the game, perform-
ing both cytology and histology and working in close cooperation with the radiologist and the
orthopedic surgeon. Nevertheless, the clinical orthopedist and oncologist have to be aware of
the diffi culty of some cases in which the true nature of the process is unpredictable or the fi nal
vii
viii Foreword
diagnosis cannot be established with absolute precision. To help in clarifying the tumor type,
each chapter provides clues for the differential diagnosis, facilitating this task.
T oday, the new advances in the molecular biology of cancer attract particular attention,
especially in the case of bone disease and bone tumors. Major interest is devoted to this fi eld
and in the practical applications oriented toward the differential diagnosis and prognosis. This
is a completely new fi eld not generally covered by other bone tumor books due to its continu-
ous advances and novelties.
T he present book is a collaborative cooperation by numerous highly distinguished bone and
osteoarticular pathologists, under the outstanding guidance of the four main editors: Drs.
Eduardo Santini-Araujo (Argentina), Ricardo K. Kalil (Brazil), Franco Bertoni (Italy), and
Yong-Koo Park (Korea). All are well known in this fi eld, and their multiple contributions to the
literature of bone pathology reinforce the high quality not only of their own chapters but also
that of the ample selection of coauthors heading each chapter. Many of them are leaders in
their fi eld and provide seminal and novel information in a clear and practical format in which
not only high-quality histological images exemplify each chapter but also excellent diagnostic
illustrations complement the comprehensive overview of the patient pathology in which major
clinical insights are also considered.
Particular thanks go to these colleagues, all editors, or authors in their own right, for having
agreed to participate in this new challenge, adding their admirable expertise to the work. In this
context, we want to extend our warmest appreciation to them.
Most essential has been the task performed by Springer-Verlag in providing the orientation
to maintain the high quality of the book and also in accepting the additional costs involved in
producing the comprehensive iconography considered necessary by all four editors to attain
the level of excellence and utility of this book.

Valencia, Spain Antonio Llombart-Bosch , MD, PhD
Pref ace
T he overall intention of this book is to provide day-to-day assistance in tumors and tumor-like
lesions of bone, for general surgical pathologists, radiologists, and orthopedic surgeons, with
practical image diagnosis, histopathological and molecular diagnosis, and basic therapeutic
guidelines.
Our main objective is to provide the essential information that any orthopedic surgeon,
radiologist, and surgical pathologist, whether general or specialized, in practice or training,
needs for evaluating a patient with a lesion in the area of orthopedic pathology.
The philosophy of the book is to offer generous coverage of epidemiology, clinical features,
radiology, pathology, and differential diagnosis not only for the distribution of the statistical
average of the lesion’s features but also to illustrate the standard deviations, including the clues
in the images and histopathology needed to arrive at a sharp differential diagnosis.
T o achieve this goal, we gathered a selected team of the more experienced and knowledge-
able people in this fi eld in the world, in pathology, imaging diagnosis, and oncologic orthope-
dic surgery, and who, generously, made available their unsurpassed expertise in order to make
this a most valuable tool for the practical diagnosis of tumors and tumor-like lesions of the
bone.
Buenos Aires , Argentina Eduardo Santini-Araujo
Buenos Aires , Argentina Ricardo K. Kalil
São Paulo, SP, Brazil
Bologna , Italy Franco Bertoni
Seoul , South Korea Yong-Koo Park

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