tailieunhanh - Ebook Pathology practical book (2nd edition): Part 2

(BQ) Part 2 book "Pathology practical book" presentation of content: Blood vessels and lymphatics, nervous system, male reproductive system and prostate, lymphoid system, basic cytopathologic techniques, exfoliative cytology, counting of blood cells, reticulocyte count, blood grouping,.and other contents. | Exercise 23: Blood Vessels and Lymphatics Blood Vessels and Lymphatics Atheroma Coronary Artery Capillary Haemangioma Skin Cavernous Haemangioma Liver Lymphangioma Tongue Systemic Pathology Exercise 23 ATHEROMA CORONARY ARTERY A fully-developed atherosclerotic lesion is called atheromatous plaque or atheroma. It is located most commonly in the aorta (Fig. ) and major branches of the aorta including coronaries. G/A The atheromatous plaque in the coronary is eccentrically located bulging into the lumen from one side. The plaque lesion is white to yellowish-white and may have ulcerated surface. Cut section shows firm fibrous cap and central yellowish-white soft porridge-like core. Frequently, there is grittiness owing to calcification in the lesion. FIGURE : Fully-developed atheroma. The opened up aorta shows arterial branches coming out. The intimal surface shows yellowish-white lesions, slightly raised above the surface (arrow). A few have ulcerated surface. Many of these lesions are located near the ostial openings on the intima, thus partly occluding them. 95 Systemic Pathology Exercise 23: Blood Vessels and Lymphatics FIGURE : A, Diagrammatic view of the histologic appearance of a fully-developed atheroma. B, Atheromatous plaque showing fibrous cap and central core. M/E The appearance of plaque varies depending upon the age of lesion. However, the following features are invariably present: i. The superficial luminal part of fibrous cap is covered by endothelium and is composed of smooth muscle cells, dense connective tissue and extracellular matrix. ii. The cellular area under the fibrous cap is composed of macrophages, foam cells and lymphocytes. iii. The deeper central soft core consists of extracellular lipid material, cholesterol clefts, necrotic debris and lipid-laden foam cells (Fig. ). iv. Calcium salts are deposited in the vicinity of necrotic area and in the lipid pool deep in the thickened intima (Fig. ). CAPILLARY .