Differential Diagnosis of Tumors and Tumor-like Lesions of Bones and Joints [Hardcover]

Adam Greenspan (Author), Wolfgang Remagen (Author)

Book Description

Publication Date: January 15, 1998 | ISBN-10: 0397517106 | ISBN-13: 978-0397517107 | Edition: 1st

This volume is a comprehensive guide to the radiologic and pathologic diagnosis of bone tumors. Emphasis is placed on correlation of clinical information, radiologic findings, and pathologic material as a key step in the differential diagnosis and final diagnosis. The book describes and illustrates the radiographic and microscopic appearances of various benign and malignant lesions and explains how the radiologist and the pathologist approach the differential diagnosis. Close attention is given to common sources of error in radiologic interpretation, as well as to cases where the radiologic differential diagnosis varies from the histopathologic differential diagnosis.

Editorial Reviews

From The New England Journal of Medicine

Orthopedic surgeons who care for patients with bone tumors have seen a vast improvement in clinical outcomes in the past several years. Much of this progress can be ascribed to the multidisciplinary attack orthopedic surgeons have mounted with the help of pathologists, radiologists, medical oncologists, and radiation therapists, as well as to the surgeons' own developments in limb-sparing surgery.

The first paragraph of the first chapter of this splendid book encapsulates the modernist's approach to bone tumors by stressing the multidisciplinary approach as well as the three major caveats in treating bone tumors: "(a) do not overtreat a benign bone tumor; (b) do not undertreat a malignant bone tumor; and (c) do not take an incorrect biopsy approach to the lesion." These three caveats signify that both authors (a radiologist and a pathologist) understand the stringent requirements for surgery and also the impact that incorrect surgery may have on the overall treatment of the condition.

What the authors have put together in a polished, easy-to-read book is a concise yet erudite description of the many challenging conditions that confront the pathologist and the radiologist as they help one another arrive at an orthopedic clinical diagnosis. The clinical end point is always kept to the fore, and the authors have carefully related observations in pathology to those in radiology, with a view to enhancing the understanding of clinical and epidemiologic features. To support their very clear descriptions of pathological characteristics, the authors have used diagrams of salient points to good effect, and they have gone to great lengths to present radiographs and micrographs of specimens that are typical of the conditions they are describing. Combining accurate pathology with radiology is a difficult task, but it has been accomplished extremely well. The nuances of staining that may be obvious to pathologists are clearly described for the benefit of nonpathologists. Perhaps some emphasis might have been placed on the importance of examining multiple sections of tumors in grading the malignancy of sarcomas.

Each chapter deals with a specific component of mesenchymal tissue. The authors have included bone-forming tumors, cartilaginous tumors, fibrous tumors, round cell tumors, vascular tumors, and metastases. For each type of tumor, the chapter has been divided into sections on benign and malignant lesions, and to their credit, the authors have included only the common lesions in each category. A great effort has been made to keep the description of each condition concise and relevant and the references up to date. The authors have tried to present the imaging and histopathological features in such a way as to be complementary rather than repetitive. Of great value in each chapter is the presentation of the radiologic and pathological differential diagnoses for each of the named conditions, with the added benefit of a grading system for each category of tumors, thus allowing a sensible subcategorization of diagnoses.

There is a balanced summary of the advantages and disadvantages of plain radiography, computed tomography, and magnetic resonance imaging. Indications for each type of imaging have been highlighted, and weaknesses and strengths noted. However, there is a disappointingly small amount of information on the role of nuclear medicine and functional nuclear scans. A particular weakness of the book is the omission of cytogenetic and molecular genetic information, of which there is a rich supply in the literature. Many centers routinely perform cytogenetic studies of bone and soft-tissue sarcomas to detect ring chromosomes that may differentiate benign from low-grade primary bone tumors or specific translocations that may identify synovial sarcoma, liposarcoma, or Ewing's sarcoma. It is clear that cytogenetics has an important part to play in diagnosis and treatment decisions.

This book is well presented and has few weaknesses. It will serve radiologists and pathologists as an excellent reference on orthopedic oncology. The clarity of the information and its systematic presentation also make the book a valuable guide for residents in radiology, pathology, orthopedics, and oncology.

Reviewed by T.J. Martin, M.D., D.Sc.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Product Details

• Hardcover: 435 pages
• Publisher: Lippincott Williams & Wilkins; 1st edition (January 15, 1998)
• Language: English
• ISBN-10: 0397517106
• ISBN-13: 978-0397517107
• Product Dimensions: 11.2 x 8.7 x 1 inches
• Shipping Weight: 3.9 pounds
• Amazon Best Sellers Rank: #3,032,257 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, read author blogs, and more.