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Histology of Hyperparthyroidism

- Advanced Disease:
    - osteoclastic resorption may become so severe that no bone is seen;
    - there is granulation tissue w/ fibroblasts, giant cells, inflammatory cells, and macrophages, containing hemosiderin in many cases;
           - this is characteristic of a brown tumor of hyperparathyroidism;
    - due to increase in number of bone remodeling centers, there is increase in number of bites taken out of the bone at any one time, w/ a
            resultant increase in the amount of bone which is missing at any one time;
    - reduction in number of trabeculae;
    - increase in multinucleated giated cells in Howship's lacunae;
    - replacement of the normal cellular and marrow elements by fibrous tissue;
    - brown tumors:
           - occurs in severe cases;
           - referred to as "giant cell tumor of diaphysis"
           - microscopical exam revealed that it was composed of numerous osteoclasts with stromal hemorrhage