Frau, 82. J., chronische Herzinsuffizienz: Knochenschmerzen, Spontanfrakturen,
Schenkelhalsfraktur
Autopsiepräparat
- Rarefizierung und Atrophie der Knochenbälkchen
- Spärlich Osteoblasten und -klasten
- Weite Markräume mit Blutbildung und reichlich Fettgewebe
(über 50% der Schnittfläche des Markes)
Differentialdiagnose:
Osteomalazie (breite Osteoidsäume)
82-year-old female suffered from chronic heart failure. She experienced bone pain and
had a femoral neck fracture (specimen from autopsy).
- The scant trabeculae (a class="highlight" onClick="zoomToView(event)">Knochenbälkchen) are thinned and have lost their interconnections.
- Osteoblasts and osteoclasts are rare. However, a number of trabeculae display resorptive pitting.
- The medullary spaces are wide.
- The bone marrow is distinctly hypercellular with approximately 60% of red bone marrow and 40% of fat.
The hypercellularity is mainly due to an increased granulopoiesis.
In osteoporosis, the bone displays normal mineralization. In contrast, osteomalacia is characterized by defective
mineralization. Histological examination reveals an increase in the amount of unmineralized bone and disorganized
trabecular architecture. Of note, mineralization can only be assessed using special techniques not requiring decalcification of
tissue specimens prior to staining.
The increase in granulopoiesis indicates that the patient suffered in addition from an infection.