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Osteoprogenitor cells, also known as osteogenic cells, are stem cells in the bone that play a prodigal role in bone repair and growth (see Image. Cells in the Bone).[1] These cells are the precursors to the more specialized bone cells (osteocytes and osteoblasts) and reside in the bone marrow. Osteoprogenitor cells originate from infant mesenchymal cells and turn into spindle cells at the surface of matured bones. In developing bones, they appear more frequently and activate multifunctional stages to remodel the bones. The body loses the ability to synthesize or utilize more osteoprogenitor cells with age. Dysfunction of osteoprogenitor cells may delay ossification and lead to a spectrum of diseases such as dwarfism and Kashin-Beck disease.[2]

Bone tumors are formed within osteoprogenitor or stromal cell lineage during Paget disease (PD), which likely derive from genetic alterations related to familial Paget’s disease. During Paget’s disease, the endosteal surface undergoes active remodeling, and abnormal osteoclasts bearing nuclear inclusions occur. The fibrotic tissues in bone biopsies from PD patients are considered to be made of surplus elongated, sophisticatedly branched stromal cells that display high alkaline phosphatase levels; these cells are similar to the pre-osteogenic stromal cells located within the normal bone marrow.[13] Early and full-blown pagetic lesions show dynamic transformations in the arrangement, number, and function of stromal cells within endosteal/medullary tissue. An excessive amount of bone marrow osteoprogenitor cells in pagetic lesion areas verify earlier data on static and dynamic histomorphometry in patients with Paget’s disease. Previous data revealed that the rate of osteogenesis increases during Paget disease, but research has confirmed that there is also a surge in the birthrate of osteoblasts.[14] The quality of the new bones depends on nature and hypermineralization. Most stromal/osteoblastic abnormalities result from bone mass increment, characterized by denser and thicker trabecular structures. Another characteristic is compromised mechanical integrity caused by poor architectural organization and transformations within the mineralized matrix material.[15]