Heterotopic ossification

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Heterotopic ossification is an uncommon pathology specimen that may be considered a ditzel.

General

  • Definition of heterotopic ossification: bone formation in soft tissue.[1]
  • Injury at site.
  • May be seen in the context of tetraplegia.

Clinical:[1]

  • +/-Joint stiffness.
  • +/-Swelling.
  • +/-Pain.

Gross

  • Firm nodule.

Microscopic

Features:

  • Lamellar bone - has layering/lines (best seen with polarized light).
  • +/-Skeletal muscle (within the marrow space).

DDx:

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Lesion, Distal Phalanx of Right Little Finger, Excision:
- Dermal ossification without cartilage in benign skin with a thick keratin layer.
- NEGATIVE for evidence of malignancy.

Block letters

LESION ("HETEROTOPIC OSSIFICATION"), RIGHT FEMUR, EXCISION:
- BONE -- CONSISTENT WITH MUSCLE HETEROTOPIC OSSIFICATION.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show laminar bone with a marrow space containing adipose tissue and benign skeletal muscle. The osteocytes show no nuclear atypia. No mitotic activity is appreciated.

See also

References

  1. 1.0 1.1 Leblanc, E.; Trensz, F.; Haroun, S.; Drouin, G.; Bergeron, E.; Penton, CM.; Montanaro, F.; Roux, S. et al. (Jun 2011). "BMP-9-induced muscle heterotopic ossification requires changes to the skeletal muscle microenvironment.". J Bone Miner Res 26 (6): 1166-77. doi:10.1002/jbmr.311. PMID 21611960.