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Evidence for a 7000-Year-Old Case of Primary Hyperparathyroidism

Albert R. Zink, PhD; Stephanie Panzer, MD; Martinus Fesq-Martin, PhD; Eva Burger-Heinrich, PhD; Joachim Wahl, PhD; Andreas G. Nerlich, MD, PhD
JAMA. 2005;293(1):36-42. doi:10.1001/jama.293.1.40-c.
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Figure 1. Osseous Lesions of the Lumbar Vertebrae and Skull
Graphic Jump Location

A, Lumbar vertebra showing a deep smooth-walled erosion at the posterior aspect. B, Fused lumbar vertebrae L2 and L3 showing focal diagenetic fossilization and significant general demineralization. Arrowheads indicate level of fusion. C, Osteopenic, granular appearance of the skull vault with loss of distinct trabecular detail. This “salt and pepper skull” represents trabecular resorption within medullary bone.

Figure 2. Tunneling Osteoclasia of the Vertebral Trabeculae
Graphic Jump Location

A, Photomicrograph of a histological section of the vertebral specimen showing the typical “cookie-bite” tunneling osteoclasia of the vertebral trabeculae (asterisks) (unstained, original magnification ×400). B, For comparison, a bone tissue section of a recent case of hyperparathyroidism reveals very similar defects at the trabecular surface (asterisks) (hematoxylin-eosin, original magnification ×400).



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