Pathology of centenarians. III. Osseous system, malignant lesions, and causes of death

This third autopsy study of 23 centenarians (7 men and 16 women) included the pathologic examination of bone, the detection of malignant neoplasms, and the determination of the main and contributory causes of death. (Previous studies concerned the lungs and the cardiovascular, urogenital and digestive systems). The vertebral bone specimens showed definite osteoporosis in 14 of the 23 subjects. In some cases it was associated with kyphosis or scoliosis of the spine or a history of femoral fracture. Eight malignant neoplasms were observed in six patients. Prostatic cancers were found in three of the seven men. All the cancers were well differentiated structurally. Four latent cancers were detected at autopsy. Most of these centenarians died of bronchopneumonia or myocardial fibrosis. Death from a malignant neoplasm was uncommon, and usually the cancer was only a contributory cause. The importance of atherosclerosis prevention is stressed by the fact that atherosclerosis was the basic cause of the cardiovascular lesions that constituted a main cause of death.