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Musculoskeletal
and Skin Pathology for Medical II Students Lab 1d Paget Disease of Bone/Osteitis Deformans (11000-76570) Paget disease is a bone disorder usually occurring in older patients, and characterized by disordered bone cell activity. The histologic appearance varies depending on the state of activity of the disease. There is an:
The initial stage shows increased osteoclastic bone resorption. The active stage of mixed activity shows prominent osteoclasts and osteoblasts. The normal bony structure is destroyed, followed by irregular bone formation that results in a pathognomonic "mosaic" pattern with persistent osteoid seams (cement lines). The thickness of the bone is increased but the bone is soft and poorly mineralized. In the inactive stage, the thickened bone with the mosaic pattern of cement lines remains, but there is little osteoclastic or osteoblastic activity in multiple bones. A laboratory feature characteristic of the active phases is marked elevation of the serum alkaline phosphatase that reflects increased osteoblastic activity. Complications of Paget disease of bone include pathologic fractures (fairly common), high out put heart failure and the development of sarcoma (rare). The sarcoma is usually osteogenic sarcoma. When an older patient develops osteogenic sarcoma, consider the possibility that there is underlying Paget's disease of bone. Slides 16 & 17 | Slide 18 Digital Legends for Labs/Cases Updated January 15, 2008
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