Review Question - QID 219745

A 65-year-old male is seen in clinic with atraumatic right hip pain. He underwent a right total hip arthroplasty eight years prior at an outside institution. The operative report indicates that a metal-on-polyethylene implant was used. Laboratory evaluation reveals a white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate all within normal limits. Serum cobalt and chromium levels are elevated. After additional workup, you suspect that the patient’s symptoms are secondary to an adverse local tissue reaction. Histologic evaluation of the affected tissue would most likely show which of the following?