Bone tumors at Addis Ababa University, Ethiopia: Agreement between radiological and histopathological diagnoses, a -5-year analysis at Black-Lion Teaching Hospital

Abstract

The study aims at looking into clinical, radiological and histopathological agreement in diagnosing bone tumors
and elaborates the spectrum of bone tumors referred to Black-Lion Hospital, BLH. All bone tumor patients, who
presented to all the three departments at BLH between the study periods of December 2003 – March 2008 were
recruited. the radiological and histopathological diagnoses made were categorized separately using WHO
classification of bone tumors. Strength of agreement was measured using Cohen’s Kappa test. From the total of
216 bone tumor patients presented and biopsied in the five year period, complete information could not be
gathered only for 11 (5%) of the patients. Hence there were 111(51.3%) males and 94(48.7%) females with
histopathological tissue diagnosis of the bone tumor. Male to female ratio was nearly 1. Commonest age range
generally affected was 15-29 (7-55 years). Of the tumors histopathologically diagnosed, 36%( 74/205) of the
tumors were malignant. The commonest primary malignant tumor from bone biopsy was osteosarcoma (52/182,
28.5%). It was also the single most common clinical, radiological and histological diagnosis made. Exostosis
was second. Considering all bone tumors together, radiological diagnosis was confirmed by similar histological
diagnosis in 172 out 205 cases (84%) and the corresponding Cohen©s kappa value (0.82) showed excellent
agreement between radiological and histological diagnoses of all bone tumors. In set-ups where there is limited
or no histopathological service, joint clinical and radiological decision could lead to a higher degree of accuracy
in diagnosis of bone tumors.