Neoplasm or not? General principles of morphologic analysis of dry bone specimens

Int J Paleopathol. 2018 Jun;21:27-40. doi: 10.1016/j.ijpp.2017.02.002. Epub 2017 Mar 6.


Unlike modern diagnosticians, a paleopathologist will likely have only skeletonized human remains without medical records, radiologic studies over time, microbiologic culture results, etc. Macroscopic and radiologic analyses are usually the most accessible diagnostic methods for the study of ancient skeletal remains. This paper recommends an organized approach to the study of dry bone specimens with reference to specimen radiographs. For circumscribed lesions, the distribution (solitary vs. multifocal), character of margins, details of periosteal reactions, and remnants of mineralized matrix should point to the mechanism(s) producing the bony changes. In turn, this allows selecting a likely category of disease (e.g. neoplastic) within which a differential diagnosis can be elaborated and from which a favored specific diagnosis can be chosen.

Keywords: Differential diagnosis; Macroscopic analysis; Morphology; Paleo-oncology; Pathology; Radiology; Skeletal lesions.

Publication types

  • Historical Article

MeSH terms

  • Bone Diseases / diagnostic imaging
  • Bone Diseases / history
  • Bone Diseases / pathology
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / history
  • Bone Neoplasms / pathology*
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / pathology*
  • Diagnosis, Differential
  • Fossils / diagnostic imaging
  • Fossils / history
  • Fossils / pathology*
  • History, Ancient
  • Humans
  • Paleopathology / methods*