Morphologic change of the internal elastic lamina in Buerger's disease.
10.3346/jkms.2000.15.1.44
- Author:
Eo Jin KIM
1
;
Byung Sun CHO
;
Tae Seung LEE
;
Sang Joon KIM
;
Jeong Wook SEO
Author Information
1. Department of Pathology, Seoul National University, College of Medicine, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Thromboangiitis Obliterans;
Internal Elastic Lamina;
T-Lymphocytes
- MeSH:
Adult;
B-Lymphocytes/pathology;
Elastic Tissue/pathology;
Elastic Tissue/immunology;
Female;
Femoral Artery/pathology*;
Femoral Artery/immunology;
Femoral Artery/anatomy & histology;
Fibrosis;
Human;
Male;
Middle Age;
Popliteal Artery/pathology*;
Popliteal Artery/immunology;
Popliteal Artery/anatomy & histology;
T-Lymphocytes/pathology;
Thromboangiitis Obliterans/pathology*;
Thromboangiitis Obliterans/immunology
- From:Journal of Korean Medical Science
2000;15(1):44-48
- CountryRepublic of Korea
- Language:English
-
Abstract:
Morphologic features and pathogenesis of arterial changes occurring in Buerger's disease (thromboangiitis obliterans) are still controversial. This study describes histopathologic features of medium sized arteries from patients with Buerger's disease, particularly of the internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger's disease were analyzed by histopathological and immunohistochemical methods. The most characteristic features were total luminal obliteration, together with a varying degree of recanalization and deposition of hemosiderin pigments. Detailed analysis, however, showed marked undulation and multiplication of the internal elastic lamina (100%) associated with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration along the internal elastic lamina was seen in 71% and was associated with localized edema. Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of the thrombotic occlusion and organization of medium-sized arteries in Buerger's disease.
