Paget Disease of Bone : Polarized Light

Pagetic bone is poorly organized and very chaotic in structure. Under polarized light (right panel), one can see irregularly juxtaposed pieces of lamellar bone, interspersed with woven bone, creating a mosaic pattern. The normal outer and inner circumferential lamellae and interstitial lamellae of the cortex are completely disrupted. The left panel shows the same field under normal light. It depicts mixed lytic and sclerotic phase. The bony trabeculae are thick, irregular and plate-like with cement lines.

Image courtesy of: Dr. Ibrahim Zardawi; used with permission.