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Paget Disease of Bone : Gross Pathology

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Paget Disease of Bone (PDB) - Gross Pathology: The cortical bone is thick and wide overall but less dense and has a spongy appearance on close examination. The trabeculae of medullary bone are coarse and thick. The lytic areas appear as blood-filled lakes in the pagetic bone.

With vertebral involvement, there may be loss of height as well as increase in the width of the vertebra, creating a picture frame appearance. In late stages, the body of vertebrae is sometimes completely sclerosed producing an "ivory" vertebra. Florid Paget disease may show soft tissue extension simulating a malignancy.

Left Panel - PDB involving femur in an 88 y/o male. Right Panel - PDB involving spine in a 94 y/o male. Image copyright: pathorama.ch

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