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58-year-old man with complaints of worsening right hip pain diagnosed with metal hypersensitivity following surgery for revision of his right hip metal-on-metal total hip arthroplasty. Light microscopy (H and E, ×2.5) shows replacement of the synovial surface by fibrin (F) and dense lymphocyte aggregates (arrow) distal to the surface with an intervening layer of densely hyalinized, paucicellular tissue.
