[Pathology of spinal tumors]

The Bone Tumor Registry of Westphalia contains data on 7,400 tumors and tumor-like lesions of bone, 135 primary spinal tumors, 187 metastases, 98 plasmacytomas, 4 extranodal manifestations of Hodgkin and non-Hodgkin lymphomas of the vertebral column. The most frequent type of primary tumor is the chordoma (35 cases), followed by osteoblastoma (16 cases), eosinophil granuloma (16), and hemangioma (12 cases). Most of the metastases derive from carcinoma of the breast, bronchial carcinoma, or prostate carcinoma. The present review concentrates on differential diagnosis by means of histological examination, with particular reference to immunohistological methods. In addition, the necessity for complementary assessment of the X-ray findings and histology is emphasized. In particular, the current status of knowledge on the prognosis of primary spinal tumors is presented. In our experience, the preparation of nondecalcified plastic sections has proved especially valuable for diagnostic procedures using punch biopsy specimens.