Paget's disease is characterized by disorganized bone architecture with numerous large multinucleated osteoclasts during active phases. The late phase features thick trabeculae with prominent hematoxylinophilic cement lines at the interfaces of resorption episodes followed by deposition. Both osteoblastic and osteoclastic activities are observed in relation to the same trabeculae, contributing to a complex pattern in affected bone.

1. PAGETS DISEASE
DR AMITHA G, BDS, MDS
ORAL AND MAXILLOFACIAL PATHOLOGY

2. C OT TO N - W O O L
A P P E A R A N C E

3. A c t i v e p h a s e s h o w i n g d i s o rga n i s e d
b o n e a rc h i t e c t u re w i t h n u m e ro u s ,
l a rg e , m u l t i n u c l e a t e d o s t e o c l a s t s .
T h e s t ro m a i s v a s c u l a r a n d f i b ro u s
T h e l a t e p h a s e fe a t u re s t h i c k
t ra b e c u l a e w i t h a p ro m i n e n t m o s a i c
p a t t e r n o f p ro m i n e n t ,
h e m a t ox y p h i l i c , c e m e n t l i n e s a t t h e
i n te r fa c e s o f e p i s o d e s o f re s o r p t i o n
fo l l o w e d b y d e p o s i t i o n .

4. B o t h o s t e o b l a s t i c a n d o s t e o c l a s t i c
a c t i v i t y s e e n i n re l a t i o n t o t h e
s a m e t ra b e c u l a e

5. O S T EO C L A S T S W I T H A L A R G E ,
E C TAT I C B LO O D V E S S E L
L AT E S TA G E O F PA G E T ’ S D I S EA S E

6. Pa g e t d i s e a s e s h o w i n g v e r y
p ro m i n e n t b l u e c e m e n t l i n e s .
T h e l a m e l l a e a re a r ra n g e d
h a p h a z a rd l y g i v i n g a n o v e ra l l
e f fe c t o f a j i g s a w p u z z l e .

7. THANK YOU