Arteries: Difference between revisions
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→Microscopic examination: +Calculation |
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==Microscopic examination== | ==Microscopic examination== | ||
*Look for atherosclerosis and [[thrombosis]]. | *Look for '''atherosclerosis''' and '''[[thrombosis]]'''. | ||
*Classify atherosclerosis as mild, moderate or severe. | *Classify atherosclerosis as '''mild, moderate or severe'''. | ||
*If cross-sections were made, estimate the maximum percentage of stenosis for each artery | *If cross-sections were made, estimate the '''maximum percentage of stenosis''' for each artery. | ||
<gallery mode=packed heights=250> | <gallery mode=packed heights=250> | ||
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File:Histopathology of progressive atherosclerotic lesions.jpg|Histopathology of '''progressive atherosclerotic lesions''': Pathological intima thickening (A) has some extracellular lipid (EL) present deep in the lesion without true necrosis. Fibrous cap atheroma (B) has a well-formed necrotic core (NC) containing lipids with an overlying thick fibrous cap (FC). Fibrocalcific plaques (C) are heavily calcified lesions with or without a necrotic core.<ref name="YangFisher2017"/> | File:Histopathology of progressive atherosclerotic lesions.jpg|Histopathology of '''progressive atherosclerotic lesions''': Pathological intima thickening (A) has some extracellular lipid (EL) present deep in the lesion without true necrosis. Fibrous cap atheroma (B) has a well-formed necrotic core (NC) containing lipids with an overlying thick fibrous cap (FC). Fibrocalcific plaques (C) are heavily calcified lesions with or without a necrotic core.<ref name="YangFisher2017"/> | ||
File:Histopathology of plaque components in atherosclerosis.jpg|Histopathology of '''plaque components''' in atherosclerosis: (A) Intraplaque neovasculature (arrows); (B) intraplaque hemorrhage; (C) large areas of calcification seen as purple morula; (D) lumen [[thrombus]] (arrowhead); stained with hematoxylin and eosin (H&E); (E) macrophage infiltration; stained with CD68 antibodies.<ref name="YangFisher2017"/> | File:Histopathology of plaque components in atherosclerosis.jpg|Histopathology of '''plaque components''' in atherosclerosis: (A) Intraplaque neovasculature (arrows); (B) intraplaque hemorrhage; (C) large areas of calcification seen as purple morula; (D) lumen [[thrombus]] (arrowhead); stained with hematoxylin and eosin (H&E); (E) macrophage infiltration; stained with CD68 antibodies.<ref name="YangFisher2017"/> | ||
File:Histopathology of coronary artery atherosclerosis, annotated.jpg|Cross-sections collapse more or less after cutting, and estimations of the '''maximum percentage of stenosis''' should be made as imagined on an expanded blood vessel, as: 1-(lumen area)/(atherosclerosis area). | |||
</gallery> | </gallery> | ||
Revision as of 15:50, 22 December 2020
Author:
Mikael Häggström [note 1]
Presentations
Gross processing
A minimal gross processing of arteries includes a longitudinal dissection and inspection of tunica intima.
Consecutive cross-sections allows for a detection and estimation of atherosclerotic stenosis.
Microscopic examination
- Look for atherosclerosis and thrombosis.
- Classify atherosclerosis as mild, moderate or severe.
- If cross-sections were made, estimate the maximum percentage of stenosis for each artery.
-
Histopathology of pre-atherosclerotic intimal lesions: Intimal thickening (A) consists mainly of smooth muscle cells in a proteoglycan-rich matrix. Intimal xanthoma (B) displays intimal thickening with isolated foam cells (arrows).[1]
-
Histopathology of progressive atherosclerotic lesions: Pathological intima thickening (A) has some extracellular lipid (EL) present deep in the lesion without true necrosis. Fibrous cap atheroma (B) has a well-formed necrotic core (NC) containing lipids with an overlying thick fibrous cap (FC). Fibrocalcific plaques (C) are heavily calcified lesions with or without a necrotic core.[1]
-
Histopathology of plaque components in atherosclerosis: (A) Intraplaque neovasculature (arrows); (B) intraplaque hemorrhage; (C) large areas of calcification seen as purple morula; (D) lumen thrombus (arrowhead); stained with hematoxylin and eosin (H&E); (E) macrophage infiltration; stained with CD68 antibodies.[1]
-
Cross-sections collapse more or less after cutting, and estimations of the maximum percentage of stenosis should be made as imagined on an expanded blood vessel, as: 1-(lumen area)/(atherosclerosis area).
![Histopathology of pre-atherosclerotic intimal lesions: Intimal thickening (A) consists mainly of smooth muscle cells in a proteoglycan-rich matrix. Intimal xanthoma (B) displays intimal thickening with isolated foam cells (arrows).[1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_pre-atherosclerotic_intimal_lesions.jpg){kind=link}
![Histopathology of progressive atherosclerotic lesions: Pathological intima thickening (A) has some extracellular lipid (EL) present deep in the lesion without true necrosis. Fibrous cap atheroma (B) has a well-formed necrotic core (NC) containing lipids with an overlying thick fibrous cap (FC). Fibrocalcific plaques (C) are heavily calcified lesions with or without a necrotic core.[1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_progressive_atherosclerotic_lesions.jpg){kind=link}
![Histopathology of plaque components in atherosclerosis: (A) Intraplaque neovasculature (arrows); (B) intraplaque hemorrhage; (C) large areas of calcification seen as purple morula; (D) lumen thrombus (arrowhead); stained with hematoxylin and eosin (H&E); (E) macrophage infiltration; stained with CD68 antibodies.[1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_plaque_components_in_atherosclerosis.jpg){kind=link}
Microscopy report
- Classify any atherosclerosis as mild, moderate or severe.
- If cross-sections were made, state the maximum percentage of stenosis for each artery.
Example:
| Sections of the three main coronary arteries reveal << mild / moderate / severe>> atherosclerosis, with approximately __%, __% and __% stenosis of the left anterior descending, left circumflex coronary artery and right coronary artery, respectively. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 1.2 Yang, Wen Jie; Fisher, Mark; Zheng, Lu; Niu, Chun Bo; Paganini-Hill, Annlia; Zhao, Hai Lu; Xu, Yun; Wong, Ka Sing; et al. (2017). "Histological Characteristics of Intracranial Atherosclerosis in a Chinese Population: A Postmortem Study ". Frontiers in Neurology 8. doi:. ISSN 1664-2295.
Image sources