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

Carlos E. De Andrea, Herman M. Kroon, Ron Wolterbeek, Salvatore Romeo, Andrew E. Rosenberg, Barry R. De Young, Bernadette Liegl, Carrie Y. Inwards, Esther Hauben, Edward F. McCarthy, Miguel Idoate, Nicholas A. Athanasou, Kevin B. Jones, Pancras C.W. Hogendoorn, Judith V.M.G. Bovée

Research output: Contribution to journalReview article

Abstract

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 coefficient0.78). 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.

Original languageEnglish (US)
Pages (from-to)1275-1283
Number of pages9
JournalModern Pathology
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2012

Keywords

  • bone tumors
  • cartilage tumors
  • chondrosarcoma
  • diagnostic criteria
  • osteochondroma
  • peripheral

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Interobserver reliability in the histopathological diagnosis of cartilaginous tumors in patients with multiple osteochondromas'. Together they form a unique fingerprint.

  • Cite this

    De Andrea, C. E., Kroon, H. M., Wolterbeek, R., Romeo, S., Rosenberg, A. E., De Young, B. R., Liegl, B., Inwards, C. Y., Hauben, E., McCarthy, E. F., Idoate, M., Athanasou, N. A., Jones, K. B., Hogendoorn, P. C. W., & Bovée, J. V. M. G. (2012). Interobserver reliability in the histopathological diagnosis of cartilaginous tumors in patients with multiple osteochondromas. Modern Pathology, 25(9), 1275-1283. https://doi.org/10.1038/modpathol.2012.78