A minimal gross processing of arteries includes a longitudinal dissection and inspection of tunica intima.
Consecutive cross-sections allows for a detection and estimation of atherosclerotic stenosis.
- Look for atherosclerosis and thrombosis.
- Classify atherosclerosis as mild, moderate or severe.
- If cross-sections were made, estimate the maximum percentage of stenosis for each artery. Cross-sections collapse more or less after cutting, and estimations should be made as if the walls again took a circular shape.
Histopathology of pre-atherosclerotic intimal lesions: Intimal thickening (A) consists mainly of smooth muscle cells in a proteoglycan-rich matrix. Intimal xanthoma (B) displays intimal thickening with isolated foam cells (arrows).
Histopathology of progressive atherosclerotic lesions: Pathological intima thickening (A) has some extracellular lipid (EL) present deep in the lesion without true necrosis. Fibrous cap atheroma (B) has a well-formed necrotic core (NC) containing lipids with an overlying thick fibrous cap (FC). Fibrocalcific plaques (C) are heavily calcified lesions with or without a necrotic core.
Histopathology of plaque components in atherosclerosis: (A) Intraplaque neovasculature (arrows); (B) intraplaque hemorrhage; (C) large areas of calcification seen as purple morula; (D) lumen thrombus (arrowhead); stained with hematoxylin and eosin (H&E); (E) macrophage infiltration; stained with CD68 antibodies.
- Classify any atherosclerosis as mild, moderate or severe.
- If cross-sections were made, state the maximum percentage of stenosis for each artery.
|Sections of the three main coronary arteries reveal << mild / moderate / severe>> atherosclerosis, with approximately __%, __% and __% stenosis of the left anterior descending, left circumflex coronary artery and right coronary artery, respectively.|
- Yang, Wen Jie; Fisher, Mark; Zheng, Lu; Niu, Chun Bo; Paganini-Hill, Annlia; Zhao, Hai Lu; Xu, Yun; Wong, Ka Sing; et al. (2017). "Histological Characteristics of Intracranial Atherosclerosis in a Chinese Population: A Postmortem Study ". Frontiers in Neurology 8. doi:10.3389/fneur.2017.00488. ISSN 1664-2295.