Bone Pathology: Diagnosis Guides

Section Editor: Bibianna Purgina MD FRCPC
October 6, 2026


Bones make up the skeleton, the framework that supports the body, protects the organs, and works with muscles to allow movement. Bone is living tissue that is constantly renewed. When a piece of bone is removed or sampled, a pathologist examines it under a microscope and describes what they see in your pathology report.

This page brings together our guides to bone conditions. The articles are grouped by type to help you find the one that matches your diagnosis. Select any article below to learn more.

Cancers of the bone

These diagnoses are cancers that develop in bone. Some, such as osteosarcoma and chondrosarcoma, start in the bone itself. The articles explain how each type is diagnosed and what the details in your pathology report mean.

Osteosarcoma

Osteosarcoma is the most common type of cancer that starts in bone. It develops from the cells that normally build new bone. This article gives an overview of the diagnosis and its types.

You may find this helpful if your report mentions osteosarcoma, or you want a general overview before reading about a specific type.

Chondroblastic osteosarcoma

Chondroblastic osteosarcoma is a type of osteosarcoma in which much of the tumor is made of cartilage. This article explains what this diagnosis means and how it differs from chondrosarcoma.

You may find this helpful if your report mentions chondroblastic osteosarcoma.

Telangiectatic osteosarcoma

Telangiectatic osteosarcoma is a rare, high-grade type of osteosarcoma made mostly of large spaces filled with blood. This article explains what this diagnosis means and how it differs from an aneurysmal bone cyst.

You may find this helpful if your report mentions telangiectatic osteosarcoma.

Parosteal osteosarcoma

Parosteal osteosarcoma is an uncommon type of osteosarcoma that grows on the surface of a bone. It usually grows slowly and has a good outlook. This article explains what this diagnosis means.

You may find this helpful if your report mentions parosteal osteosarcoma.

Periosteal osteosarcoma

Periosteal osteosarcoma is a rare type of osteosarcoma that grows on the surface of a bone and is made mostly of cartilage. It is intermediate grade and has a better outlook than most osteosarcomas. This article explains what this diagnosis means.

You may find this helpful if your report mentions periosteal osteosarcoma.

High-grade surface osteosarcoma

High-grade surface osteosarcoma is a very rare, fast-growing type of osteosarcoma that starts on the surface of a bone. It is treated the same way as the common type of osteosarcoma. This article explains what this diagnosis means.

You may find this helpful if your report mentions high-grade surface osteosarcoma.

Low-grade central osteosarcoma

Low-grade central osteosarcoma is an uncommon, slow-growing type of osteosarcoma that develops inside a bone. This article explains what this diagnosis means.

You may find this helpful if your report mentions low-grade central osteosarcoma or LGCOS.

Chondrosarcoma

Chondrosarcoma is a bone cancer made of cartilage and one of the most common bone cancers in adults. This article provides an overview of diagnosis, grades, and types.

You may find this helpful if your report mentions chondrosarcoma, or you want a general overview before reading about a specific grade or type.

Chondrosarcoma grade 1

Chondrosarcoma grade 1 is a slow-growing cartilage cancer that develops in the pelvis, shoulder blade, spine, or base of the skull. This article explains what this diagnosis means and why location matters.

You may find this helpful if your report mentions chondrosarcoma grade 1 or low-grade chondrosarcoma.

Chondrosarcoma grade 2

Chondrosarcoma grade 2 is a cartilage cancer of bone. The grade describes how the cells look under the microscope and how the tumor is likely to behave. This article explains what this diagnosis means.

You may find this helpful if your report mentions chondrosarcoma grade 2 or intermediate-grade chondrosarcoma.

Chondrosarcoma grade 3

Chondrosarcoma grade 3 is a cartilage cancer of bone. It is the highest grade, meaning the cells look the most abnormal and the tumor grows the fastest. This article explains what this diagnosis means.

You may find this helpful if your report mentions chondrosarcoma grade 3 or high-grade chondrosarcoma.

Dedifferentiated chondrosarcoma

Dedifferentiated chondrosarcoma is an uncommon, fast-growing bone cancer made of two parts: a slow-growing cartilage tumor and a high-grade cancer that no longer makes cartilage. This article explains what this diagnosis means.

You may find this helpful if your report mentions dedifferentiated chondrosarcoma.

Clear cell chondrosarcoma

Clear cell chondrosarcoma is a rare, slow-growing cartilage cancer that develops at the end of a long bone, usually near the hip or shoulder. This article explains what this diagnosis means.

You may find this helpful if your report mentions clear cell chondrosarcoma.

Chordoma

Chordoma is a rare, slow-growing bone cancer that develops along the spine or at the base of the skull. This article explains how it is diagnosed and what your pathology report describes.

You may find this helpful if your report mentions chordoma or brachyury.

Plasmacytoma

A plasmacytoma is a tumor made of plasma cells, a type of immune cell. When it occurs in bone, it forms a single mass. This article explains what this diagnosis means and how it relates to multiple myeloma.

You may find this helpful if your report mentions a plasmacytoma or solitary plasmacytoma of bone.

Locally aggressive tumors

These diagnoses are bone tumors that fall between clearly noncancerous and cancerous. They can grow into nearby bone and come back after treatment, but they rarely spread to other parts of the body. The articles explain what each diagnosis means.

Giant cell tumor of bone

A giant cell tumor of bone is a tumor that can grow into nearby bone and come back after treatment, but only rarely spreads to other parts of the body. This article explains what this diagnosis means.

You may find this helpful if your report mentions a giant cell tumor of bone or H3.3 G34W.

Central atypical cartilaginous tumor

A central atypical cartilaginous tumor is a slow-growing cartilage tumor that develops inside a bone of the arms or legs. It can grow into nearby bone but almost never spreads. This article explains what this diagnosis means.

You may find this helpful if your report mentions an atypical cartilaginous tumor or ACT, or an older report described a tumor in an arm or leg as chondrosarcoma grade 1.

Noncancerous tumors

These diagnoses are noncancerous bone tumors. They do not spread to other parts of the body and are often found by chance on an X-ray done for another reason. The articles explain each diagnosis.

Osteochondroma

An osteochondroma is the most common noncancerous bone tumor. It is a bony growth, capped with cartilage, that develops on the surface of a bone. This article explains what this diagnosis means.

You may find this helpful if your report mentions an osteochondroma, an exostosis, or multiple osteochondromas.

Enchondroma

An enchondroma is a common, noncancerous cartilage tumor that develops inside a bone, often in the hand. It is often found by chance. This article explains what this diagnosis means.

You may find this helpful if your report mentions an enchondroma, Ollier disease, or Maffucci syndrome.

Osteoid osteoma

An osteoid osteoma is a small, noncancerous bone tumor that often causes pain at night. This article explains what this diagnosis means.

You may find this helpful if your report mentions an osteoid osteoma or a nidus.

Osteoblastoma

An osteoblastoma is an uncommon, noncancerous bone tumor. It is similar to an osteoid osteoma but larger, and it most often develops in the spine. This article explains what this diagnosis means.

You may find this helpful if your report mentions an osteoblastoma or epithelioid osteoblastoma.

Fibrous dysplasia

Fibrous dysplasia is a noncancerous condition in which an area of normal bone is replaced by fibrous tissue and weak, immature bone. This article explains what this diagnosis means.

You may find this helpful if your report mentions fibrous dysplasia or a GNAS change.

Aneurysmal bone cyst

An aneurysmal bone cyst is a noncancerous, blood-filled growth that develops inside a bone. This article explains what this diagnosis means and how it is treated.

You may find this helpful if your report mentions an aneurysmal bone cyst or ABC.

Noncancerous conditions

These diagnoses are noncancerous bone conditions. The articles explain what a pathologist looks for.

Fracture

A fracture is a break in a bone. This article explains what a pathologist looks for when examining bone after a fracture, including signs of a disease that weakened the bone.

You may find this helpful if your report mentions a fracture, a pathologic fracture, or a fracture callus.

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