Atherosclerosis

Figure 1. Pulmonary Artery

Figure 2. Thoracic Aorta

athero1athero2

plaq3plaq4

Figures 1 and 2 are from the 52-year-old man. Note that the pulmonary artery has multiple atheromatous plaques as does the thoracic aorta. Normally, atheroma is absent from the pulmonary artery.

Find 2 plaques in the pulmonary artery and 2 in the aorta.

atheromamedia

Figure 3. Histology of Atheroma

This thickened wall of a proximal, elastic pulmonary artery shows marked intimal fibrosis. A central necrotic atheroma has cholesterol clefts. Multinucleated giant cells and foamy macrophages cannot be seen at this power.

The adventitia is at the bottom.

Find the necrotic atheroma.

Find the arterial media.

Comment: The necrotic atheromatous foci may undergo calcification, corresponding to that seen on radiographs and CTs in vessel walls. This process of calcification in necrotic foci is called dystrophic calcification. It occurs with normal serum calcium levels. Metastatic calcification occurs in normal tissues when the serum calcium is elevated.

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