The above-mentioned bone biopsy study recruited another patient with ESKD who underwent parathyroidectomy 12 months ago with a similar preoperative clinical profile. However, he developed progressive cognitive dysfunction a few months post-parathyroidectomy. The bone histopathological pictures are presented in figure 2 &3.
lack of cells with positive aluminium staining represents aluminium induced osteomalacia
b Alumiun enters bone and causes mineralisation disruption as well stopping cell activity
C- Interpret the above bone slides.
Increase in osteoid volume, an increase in the fraction of wide osteoid seams, with defect mineralization of bone protein. aluminium deposition at mineralization front
D- What might explain the histopathological discord between the two pictures?
Aluminum overload causes defective mineralization, increased matrix synthesis by osteoblasts, inhibition of osteoblast differentiation, and the inhibition of osteoclast function
C-aluminum deposition with hypocellularity lead to ABD
D-aluminum deposition lead to demineralization
C- Interpret the above bone slides.
Hypercellularity with low osteoclasts and osteoblasts, high osteoid bone, and minerzliation defect. It also showing aluminum deposition in the second slide.
D- What might explain the histopathological discord between the two pictures?
Aluminum deposition causes mineraliztion defect.
C- Interpret the above bone slides.ELEVATED OSTEOID VOLUME WITH POSSITIVE ALUMINUM STAINING
D- What might explain the histopathological discord between the two pictures?DEFICIENT MINERALIZATION AND ALUMINUM DEPOSITION IN THE BONE
Model answer by the board:
C. Interpret the above bone slides.
High osteoid volume with paucity of bone cells together with positive Aluminum staining is suggestive for Aluminum induced osteomalacia.
D. What might explain the histopathological discord between the two pictures?
The patient with Aluminum staining has defective mineralization that results from Aluminum accumulation in the bone. Aluminum is transported into the bone, where it disrupts mineralization and bone cell growth and activity.
C. Increased osteoid thickness, decreased mineralization, no osteoblasts and osteoclasts . Positive aluminium deposit.
D. Osteomalacia due to aluminium intoxication
C- Interpret the above bone slides.No osteoblasts
No osteoclasts
No mineralization
Positive aluminum deposition
D- What might explain the histopathological discord between the two pictures?Aluminum toxicity causing osteomalacia
The osteoid is thick but the mineralization is defective. in figure 3 there is aluminum deposition (red lining) which inhibits mineralization
C- Interpret the above bone slides.
figure 2
there is areas of thick and thin osteoid
no osteoblasts
no osteoclasts
normal bone volume
no mineralization
figure 3
aluminum rim cover more than 15% of the bone as shown by solo chrome azurine stain for aluminum..
What might explain the histopathological discord between the two pictures?
osteomalacia due to aluminum toxicity
C- Interpret the above bone slides.
D- What might explain the histopathological discord between the two pictures?
C- Interpret the above bone slides.
D- What might explain the histopathological discord between the two pictures?
C- Interpret the above bone slides.
No osteoblast or osteoclast, increase osteoid surface
Positive aluminum deposition
D- What might explain the histopathological discord between the two pictures?
Aluminum toxicity causing osteomalacia
Interpret the above bone slides decreased no of osteoblasts and osteoclasts. increased ostoid surfaces,
solochrome stain shows aluminium deposits along bone surface
What might explain the histopathological discord between the two pictures the patient has osteomalacia 2ry to aluminium toxicity
Interpret the above bone slides.
What might explain the histopathological discord between the two pictures?Aluminium toxicity, ABD
C- Interpret the above bone slides.
No bone cells, undermineralization
D- What might explain the histopathological discord between the two pictures?
Aluminium Toxicity
D- A case of aluminium intoxication inducing osteomalacia
C- Interpret the above bone slides.
Figure 2 high oesteoid volume with low bone turn over
Figure 3 show aluminum deposition in oesteoid surfaces with mineralization defect acase of oesteomalicia
D- What might explain the
histopathological discord between the two pictures?
Ostoid formation no bone cell
due aluminium intoxication
figure 2 : increased osteoid volume, defective mineralization, no visualised osteoblast or osteoclast (picture of mineralization defect osteomalacia)
figure 3 is stained for Aluminum using Solochrome azurine: positive staining foe aluminium
What might explain the histopathological discord between the two pictures?A case of aluminium intoxication inducing osteomalacia and low turn over bone disease
Interpret the above bone slides.this slid showed increased ostoid with no bone cells
there is Aluminum positive line
What might explain the histopathological discord between the two pictures?
This histomophometric showed features of ABD
C- Interpret the above bone slides.
D- What might explain the histopathological discord between the two pictures?
positive aluminum staining with picture of aluminum intoxication
C- Interpret the above bone slides.
D- What might explain the histopathological discord between the two pictures?
C- Interpret the above bone slides?
1.Figure 2
2.Figure 3
D. What might explain the histopathological discord between the two pictures?
C- Interpret the above bone slides.Excess osteoid (unmineralized bone matrix) accumulation
Widened osteoid seams
Increased osteoid volume, low osteoclast, and osteoblast activity
Osteomalacia picture.
figure 3 is stained for Aluminum using Solochrome azurine: positive aluminum stainingD- What might explain the histopathological discord between the two pictures?positive aluminum staining. osteomalacia secondary to aluminum intoxication
i think ????
slide figer 2 >>show post parathyroidectomy over activity of implanted part
slide figer 3 >>>aluminum intoxication low bone turn over picture
??? need opinion and explanation of our prof
C- positive staining with Aluminum specific stains in more than 25% of bone structures consistant with AL intoxication