Differential Vascularity in Genetic and Nonhereditary Heterotopic Ossification

Int J Surg Pathol. 2019 Dec;27(8):859-867. doi: 10.1177/1066896919857135. Epub 2019 Jun 28.

Abstract

Introduction. Nonhereditary heterotopic ossification (NHO) is a common complication of trauma. Progressive osseous heteroplasia (POH) and fibrodysplasia ossificans progressiva (FOP) are rare genetic causes of heterotopic bone. In this article, we detail the vascular patterning associated with genetic versus NHO. Methods. Vascular histomorphometric analysis was performed on patient samples from POH, FOP, and NHO. Endpoints for analysis included blood vessel (BV) number, area, density, size, and wall thickness. Results. Results demonstrated conserved temporal dynamic changes in vascularity across all heterotopic ossification lesions. Immature areas had the highest BV number, while the more mature foci had the highest BV area. Most vascular parameters were significantly increased in genetic as compared with NHO. Discussion. In sum, both genetic and NHO show temporospatial variation in vascularity. These findings suggest that angiogenic pathways are potential therapeutic targets in both genetic and nonhereditary forms of heterotopic ossification.

Keywords: angiogenesis; fibrodysplasia ossificans progressive; heterotopic bone; heterotopic ossification; progressive heterotopic ossification.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biopsy
  • Bone Diseases, Metabolic / diagnosis*
  • Bone Diseases, Metabolic / genetics
  • Bone Diseases, Metabolic / pathology
  • Bone and Bones / blood supply*
  • Bone and Bones / pathology
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Humans
  • Male
  • Mutation
  • Myositis Ossificans / diagnosis*
  • Myositis Ossificans / genetics
  • Myositis Ossificans / pathology
  • Ossification, Heterotopic / diagnosis*
  • Ossification, Heterotopic / etiology
  • Ossification, Heterotopic / genetics
  • Ossification, Heterotopic / pathology
  • Skin Diseases, Genetic / diagnosis*
  • Skin Diseases, Genetic / genetics
  • Skin Diseases, Genetic / pathology
  • Spatio-Temporal Analysis
  • Wounds and Injuries / complications*

Supplementary concepts

  • Osseous Heteroplasia, Progressive