Técnicas especiales en el diagnóstico de tumores óseos

Abstract

In terms of diagnosis and prognosis, the present value of different sophisticated techniques applied for the patologist on bone tumors is reviewed. Histochemically, alkaline phosphatase and PAS techniques are both very important for the diagnosis of osteosarcoma and Ewing's sarcoma respectively. The value of electronic microscopy and immunohistochemistry for diagnosis of round small cells tumors (Ewing's sarcoma, neuroectodermic tumors, primary bone lymphoma and metastatic neuroblastoma) and fusocellular sarcomas (fibrosarcoma, leiomyosarcoma of bone and synovial sarcoma) isdiscussed. The differential diagnosis of chondrosarcoma, chordoma and metastatic mucosecretor carcinoma at the spine by using immunohistochemistry is reviewed. The aplication of cytology is very limited and only useful in the hands of patologist expert in bone tumors. Recent studies on cellular ploidy using the techniques of flow and static cytometry have shown prognostic value in certain tumors such as chondrosarcoma. The future seem s to be cytogenetics as have been demostrated already for Ewing sarcoma.