Histologic Changes

These small arteries, 150 µm in diameter, are both abnormal. That on the right has intimal and medial thickening. That on the left appears to have a recanalized thrombus with multiple channels. An elastic tissue stain showed that the elastic laminas were absent indicating that this is a plexiform lesion.

 

A similar vessel, 160 µm in diameter, stained with the elastic-van Gieson stain shows a single elastic layer around a plexiform lesion that resembles a recanalized thrombus (large arrow). Another part of the vessel that is thrombosed has two elastic layers (paired small arrows).

On the other hand, this vessel (490 µm diameter) (from another case) is a thrombotic lesion with intact elastic laminas and a recanalized thrombus in the lumen. This thrombotic lesion can be distinguished from a thromboembolus only by the clinical context.

Clinical summaryImage 4

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