True trilineage haematopoiesis in excised heterotopic ossification from a laparotomy scar: report of a case and literature review

Abstract

We report a case of true trilineage haematopoiesis in an excised area of heterotopic ossification from an upper mid-line laparotomy scar. Heterotopic ossification is a rare complication of abdominal surgery and usually occurs when upper mid-line incisions are utilised. Whereas cases of heterotopic ossification in abdominal incisions are not exceedingly rare, true trilineage haematopoiesis in such an area of heterotopic ossification, to our knowledge, has only been previously reported once in the English literature.

Macrophage-derived oncostatin M contributes to human and mouse neurogenic heterotopic ossifications

“…Hematopoietic marrow-like tissue has been observed in the center of HOs on histological sections, as described in two case reports (8,9). Recently, the presence of clonogenic hematopoietic progenitors Neurogenic heterotopic ossification (NHO) is the formation of ectopic bone generally in muscles surrounding joints following spinal cord or brain injury.…”

Pathophysiology of Heterotopic Ossification

“…Patients can develop HO in the kidney, gastrointestinal tract, and uterus as well as following abdominal surgery (Shehab et al, 2002 ). Following abdominal surgery, the greatest incidence of HO occurs in men older than 55 years (Christofi , Raptis, Kallis, & Ambasakoor, 2008).…”

“…Some of the most common conditions that can precipitate the development of HO include an SCI, musculoskeletal trauma, surgical intervention, or traumatic brain injury (Frassica et al, 2006 ). An agent must be produced or released following the instigating event that has the potential to initiate the development of HO (Christofi et al, 2008 ). Precursor cells with the potential to become the bone of HO must be present within a cellular environment that will support this change (Shehab et al, 2002 ).…”

“…A decrease in antagonists to BMP can also allow for and increased production and release of this induction factor. Follistatin and chordin are two such BMP antagonists (Christofi et al, 2008 ).…”

“…An increase in BMP can lead to an increase in osteogenic cell differentiation (Christofi et al, 2008 ). This inducing factor is a polypeptide that can stimulate the differentiation of mesenchymal cells to develop into chondrocytes and eventually osteoblasts (Shehab et al, 2002 ).…”