Pathomorphology- Cardiovascular Part 2

7/23/2019 Pathomorphology- Cardiovascular Part 2

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Pathomorph lab #13: Cardiovascular Part 2

1) Atheromatous plaque of the aorta (H&E 273),(Sudan 274)

Disease of large and medium sized arteries that result in the

progressive accumulation within the intima of smooth musclecells and lipids.

Cells in the intima can transform into phagocytes

Tunica intima of elastic and muscular arteries

o The proliferation of intimal smooth muscle cells and the

accumulation of lipidso Endothelium breaks down and platelets are deposited

Neovascularization of plaque vasa plaquorum!

"rossly# brofatt plaque

o The fbrouscap# layer of connective tissue

o Thick intima with fat#$lled macrophages foam cells!

and smooth muscle cellso Early stage# fatty streako The atheroma# necrotic mass of lipid atherosclerotic

lesiono Especially seen in bifurcation of aorta% abdominal aorta%

or arch of aorta

Complications&

o 'schemic heart disease (ost commonly causes this!

o (' by ) mechanisms#

*! rupture of plaque and bleeding into plaque

causes the lumen to close main reason is caused

by atherosclerosis! )! thrombosis blocks distal part of artery

+troke

"angrene of the e,tremities

Thrombosis% emboli

2) Hal!ne arter!olos"leros!s of the #!dne (2$3) Chronic hypertension leads to reactive changes in the smaller

arteries and arterioles throughout the body. These changesare collectively referred to as arter!os"leros!s% 'n the

arterioles% the alterations are also known asarter!olos"leros!s%

en!'n arter!os"leros!s variable increase in thickness ofvessel walls


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o in smallest arteries and arterioles- hyaline

arteriosclerosiso /yaline0# glassy% scarred appearance of blood vessel

walls seen by light microscopy

1alls are thickened by deposition of basement membrane

material and by accumulation of plasma proteins The small muscular arteries display new layers of elastin%

presenting a reduplication of intimal elastic lamina and anincrease in connective tissue

2enign arteriosclerosis# kidney pathology% results in loss ofrenal parenchyma

o +clerosis of renal arterioles and small arteries

o 3ging% genetic disorders% hemodynamic disorders% in4ury

of endotheliumo Diabetes% hypertension

(icro&

o Thickening and hyalinization of the wall

o +mooth muscle cell proliferation onion#skin0

o Narrowing of the lumen% regional scars in kidney

parenchyma

3) al!'nant nephros"leros!s (H&E) (3*3), (a+an)(3*4)

5orm of renal disease associated with malignant phase of

hypertension

+mall muscular arteries# segmental dilatation as a result ofnecrosis of smooth muscle cells.

5ibrin and the entry of plasma proteins into the vessel wall.

The combination of cells necrosis and deposition of plasmaproteins is termed 6 br!n!od ne"ros!s% A+an sta!n!n' !sneeded for th!s%

The period of acute in4ury is rapidly followed

o +mooth muscle proliferation

o +triking concentric increase in the number of layers of

smooth muscle cells.

7esult# on!on s#!n-appearance.

Complications# increased intracranial pressure% renal failure%

and 89: of mortality within ; months of onset.

4) .olarter!t!s nodosa (the #!dne) (3**) +mall and medium sized muscular arteries

Children and young adults


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Common in parts of Central 3frica% 3'Ds related and immune#compromised patients.

Tumor in the B# decades of life men ,*9 than women!

1idespread% multifocal lesion related to the loss of immunity!

Transplant#

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Pathomorphology- Cardiovascular Part 2