[Paget's disease of bone: ultrastructure and cytogenesis of osteoclasts (author's transl)]

The cytogenesis of giant osteoclasts in Paget's disease of bone was studied by means of electron microscopy. 26 iliac crest biopsies were made and divided for light and electron microscopic investigation. A special procedure was used for electron microscopic preparation of bone without previous decalcification. Paget osteoclasts are characterized by their high content of nuclei. Several nuclei may show paracrystalline inclusions pointing to a possible virus infection of these cells. Giant osteoclasts have an increased mobility and a high resorptive activity, manifest by the dissection of bone fragments from endosteal bone surfaces. Cell membrane interdigitations between mononuclear cells and osteoclasts occur as a morphologic concomitant of cell fusion. Frequent occurence of such cell membrane contacts seem to indicate an increased tendency to cell fusion among the mononuclear precursors of Paget-osteoclasts. Precursor cells are located in the pericapillary region, and morphologically resemble pericytes. The assumption of an increased rate of cell fusion amoungst the precursor cells of osteoclasts might explain the development of giant osteoclasts in this disease. Further studies of the paracrystalline nuclear inclusions of Paget-osteoclasts are necessary to determine whether this process can be considered to be a cytopathogenic effect of virus infection.