Elm Leaves curling with worms?

Stillwater, OK

Some of the leaves on my very old American Elm tree are falling and are curled with these green worms or growths inside. What is going on here? Thanks!

Thumbnail by casscc1
Contra Costa County, CA(Zone 9b)

http://www.extension.umn.edu/garden/diagnose/plant/deciduous/elm/leavesprojections.html

A few possibilities here.

Stillwater, OK

Thank you! It looks just like the Elm finger gall picture.

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