Vascular Diseases

Pulmonary veno-occlusive disease

Features are: Veins (in interlobular septa) or venules (below) are narrowed or occluded by hyaline or loose cellular intimal thickening. Multiple lumens suggest recanalized thrombi. Arteries show some medial and intimal thickening.

The arrows mark the boundaries of a vein in an interlobular septum. Note the surrounding capillary congestion.

This elastic van Gieson stain colors the elastic layer of a venule black (arrow). The lumen is narrowed by loose connective tissue. Again, note the congestion of the surrounding capillaries. Bleeding and hemosiderosis may occur.

Arterial thromboembolic disease

This elastic van Gieson stain shows the inner and outer elastic layers of a muscular artery. The media is normal. The lumen has a fibrous mesh of a recanalized thrombus or embolus.

Embolic disease may be accompanied by pulmonary hemorrhage or infarction. It can result in hypertension. Thrombotic disease occurs with lung inflammation, in one form of primary pulmonary hypertension, and in sickle cell disease.

Arteriovenous malformation (AVM)

AVMs (often associated with Weber-Rendu-Osler disease) are composed of collections of enlarged vascular channels. They are fed by either the bronchial or pulmonary arteries. Here, an AVM has some chronic inflammatory cells in its wall.

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