ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The carotid endarterectomy specimen must be sectioned transversely after decalcification and the carotid plaque morphology described. Thrombosis in carotid atherosclerotic disease occurs predominantly from plaque rupture with ulceration due to embolization of thrombus and necrotic core and is more frequent in symptomatic than asymptomatic disease. Less frequently thrombosis is the result of calcified nodule or plaque erosion. Hemorrhage and calcification are commonly observed and are equally observed in symptomatic and asymptomatic disease. Recurrent endarterectomy lesions of short duration are secondary to fibrointimal hyperplasia and late recurrent disease occurs from atherosclerosis.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Coronary thrombosis is a major cause of acute myocardial infarction and sudden death in adults. Thrombi are the cause of the majority of acute infarcts, but are detected in only one-half of sudden death victims who die from severe coronary artery disease. The most common substrate of acute coronary thrombosis is plaque rupture, in which necrotic core is exposed to the luminal blood by a break in a fibrous cap that is generally infiltrated with macrophages. A less common substrate for coronary thrombosis is the plaque erosion, in which case there is denudation of the endothelial lining in direct contact with the thrombus, and a smooth muscle cell-rich plaque. Both of these types of thrombi may result in acute myocardial infarction or sudden death, or they may heal spontaneously and result in plaque enlargement. The autopsy pathologist should carefully section epicardial arteries, with special attention to decalcification, sampling of the entire tree, and deeper levels of areas of suspected plaque disruption, to prevent underdiagnosis, accurately diagnose the type of thrombus, and interpret the likely clinical significance of the coronary lesion.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Percutaneous endoluminal revascularization with stents has become standard practice for the treatment of coronary atherosclerosis. In his or her role to provide a clinically relevant assessment and clinicopathologic correlation, the anatomic pathologist should have an understanding of the various types of these novel arterial devices, the indications for their use, the specific pathologic findings associated with their deployment, and potential complications. Further, unlike most pathologic specimens, gross evaluation and histologic processing of vascular stents require special methods secondary to the presence of metals in direct contact with or embedded in arterial tissue. This update will review the general characteristics of stents and the procedures used in their pathologic analysis.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Giant cell arteritis is an idiopathic inflammatory disease affecting muscular and elastic arteries. Most patients are elderly, and there is a female predominance. The disease may affect virtually any arterial bed, but there is predisposition for the cranial arteries. The temporal artery is usually biopsied, because of its superficial nature, and high frequency of involvement, often with a palable mass. The diagnostic histologic feature is a macrophage infiltrate of the internal elastic lamina with destruction of the elastica. Lymphocytes and areas of necrosis may be seen. A case illustrating a subtle case of giant cell arteritis of the temporal artery is presented. The differential diagnosis, including other forms of arteritis that may affect the temproal artery, is discussed.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Heart transplantation is an accepted therapeutic option for end-stage heart failure, which gained wide acceptance during the early to mid 1980s. Since that time, the ability to diagnose, treat, and sometimes prevent early posttransplant complications, such as acute rejection and opportunistic infections, has improved dramatically. Some remaining challenges in the diagnosis of rejection on endomyocardial biopsy specimens have been discussed previously in this format (Winters GL. Grade 2 cardiac rejection: pathologic and clinical controversies.Pathology Case Rev1998;3:66–72). As a result of the above advances, allograft coronary disease has emerged as a major limitation to long-term recipient survival and, in many transplant centers, is the single entity which accounts for the most deaths in patients surviving for more than one year.Allograft coronary disease presents considerable challenges for diagnosis and treatment. Intravascular ultrasound has increasingly gained acceptance over angiography for clinical detection of this disease. The concentric intimal proliferation, which selectively involves the allograft vasculature, frequently results in secondary ischemic changes to the myocardium that may be detected on endomyocardial biopsy specimens. Although allograft coronary disease has been well described pathologically, the greatest challenge remains the better understanding of the pathogenesis of this process so that therapy may be specifically targeted and long-term recipient survival becomes routine.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The issue of anorexigen-associated valvular dysfunction and the formation of distinctive lesions predominantly on left-sided heart valves remains an area of intense scientific study and debate. Much controversy remains regarding the specific pathologic and histopathologic features of the myxomatous lesions associated with exposure to anorexigenic agents such as fenfluramine, dexfenfluramine and phentermine. The pathology of heart valve lesions associated with anorexigen exposure must be differentiated from lesions associated with ergotamine and methysergide use and from chronic rheumatic valve disease, floppy valve disease, infective endocarditis and carcinoid heart disease. Heightened awareness of heart valve disease associated with anorexigen exposure as a real pathobiological entity, together with increasing knowledge of the mechanisms involved, should lead to more effective diagnosis and treatment of affected individuals.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Arrhythmogenic right ventricular cardiomyopathy/dysplasia is a condition particularly associated with recurrent ventricular tachycardia and sudden death, often in young people and athletes. Its etiology and pathogenesis are yet unknown. A proportion of cases is familial; the usual pattern of inheritance is autosomal dominant with variable penetrance, though a recessive form has also been described. It typically involves the right ventricle with fibrofatty or fatty replacement of the myocardium; however, not infrequently, the left ventricle and septum are also affected. The changes may be localized/segmental or more generalized, macroscopic and/or microscopic. Although seemingly uncommon, except in certain parts of the world, its recognition is essential to the appropriate management of affected individuals, and to facilitate further investigation and a better understanding of the condition itself.

ISSN:1082-9784    

出版商:OVID    

年代:2001

数据来源: OVID