Radiological and Histopathological Correlative Analysis of Bone Tumors and Tumor-Like Lesions at a Tertiary Care...

Bone tumors and tumor-like lesions represent a heterogeneous group of disorders with overlapping clinical and radiological characteristics, often posing diagnostic challenges in routine practice. The present study aimed to evaluate the spectrum of bone tumors and tumor-like lesions encountered at a tertiary care hospital in eastern India and to assess the concordance between radiological and histopathological diagnoses.

This prospective observational study was conducted in the Department of Pathology over 18 months and included 125 patients with clinically and radiologically suspected bone lesions who underwent biopsy or surgical intervention. Radiological findings were correlated with histopathological examination, and concordance was assessed using Cohen's kappa statistic. A p-value <0.05 was considered significant.

Most patients were below 30 years of age (98, 78%), with male predominance (72, 58%). Swelling associated with pain (48, 38%) was the most common presenting symptom, and the femur was the most frequently involved bone. Radiological evaluation categorized 52 (42%) lesions as malignant, whereas histopathology identified malignancy in 47 (38%) cases. Osteosarcoma was the most common malignant tumor. Overall concordance between radiological and histopathological diagnoses was observed in 106 (85%) cases, with a kappa value of 0.636 indicating statistically significant moderate agreement.

Radiological evaluation demonstrated moderate agreement with histopathological diagnosis and served as an effective preliminary diagnostic modality in bone tumors and tumor-like lesions. However, histopathological examination remained essential for a definitive diagnosis because of overlapping imaging features among benign, aggressive, and malignant lesions.