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Case 397

Surgical Pathology Case



  A 72 years old male had no significant past medical history. He had a sudden right hip pain with "locked" joint while he was walking downstairs. Clinical image studies showed a fractured right femoral neck..



No tumor lesions were noted grossly. A section from the fracture neck was taken.



Microscopically, the femoral head and neck revealed normocellular bone marrow with fresh intramarrow hemorrhage, consistent with clinical fracture. A small aggregate of small uniform cells was noted. These cells had round uniform nuclei with open chromatin and a small nucleolus. The morphology of this small aggregate was suboptimal due to decalcification. By immunohistochemical staining, these cells was negative for lymphoid markers. Deeper cuts was ordered, and curettage of the bone marrow from the fracture site was submitted into three cassettes following a one-hour brief decalcification.


HE, 2, Deeper cut

HE, 4, Deeper cut


HE, 10, Deeper cut

HE, 10, Deeper cut


HE, 10, curettage specimen

HE, 10, curettage specimen


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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan