2. ATHEROSCLEROSIS
• Specific form of arteriosclerosis affecting primarily the intima of large
and medium sized muscular arteries and characterized by fibrofatty
plaques or atheroma.
• Most commonly affected vessels- aorta , coronary , cerebral arterial
system
3. ATHEROMATOUS PLAQUE
• Gross appearance-
• White to yellowish white lesion varying in diameter from
1-2 cm and raised on surface by few mm in thickness
• Fatty streak – flat or slightly elevated and yellow , either in
the form of small multiple dots , in the form of elongated
beaded streaks.
• Cut section shows firm white fibrous cap , soft , poddrige
like material hence named atheroma.
4. • Microscopy –
• Superficial luminal part of the fibrous cap is covered by
endothelium , and composed of smooth muscle cell , dense
connective tissue and extra cellular matrix containing
proteoglycans and collagen.
• Cellular area under cap is comprised of mixture of
macrophages , foam cells , lymphocytes and few smooth
muscle cell.
• Deeper central soft core consists of extra cellular lipid
materials , cholesterol clefts , fibrin , necrotic debris, lipid
laden foam cells.
6. Complicated plaque
• Various pathological changes that occur in fatty developed
atheromatous plaque are called the complicated lesion .
• Complications of atherosclerosis:
• Calcification
• Thrombosis
• Hemorrhage
• Aneurysm formation
7. Syphilitic Aortitis
• Most commonly affected in tertiary stage of syphilis ( 80% cases)
• Affected vessels:
• Ascending aorta
• Aortic arch
• Gross : Affected part of aorta maybe dilated and its wall thickened
and adherent to the mediastinal structure.
• Intimal surface – pearly white thickening ( tree bark like
appearance)
8. • Microscopy:
• Endarteritis and periarteritis of vasa vasorum located in the media and
adventitia.
• Perivascular accumulation of the plasma cell lymphocytes and macrophages,
forming milliary gummas, which undergo necrosis.
9. COR-BOVINUM
• Cor bovinum refers to a massive hypertrophy of the left ventricle of
the heart due to volume overload.
• seen in tertiary syphilis
• due to chronic aortic regurgitation
10. MYOCARDIAL INFARCTION
• Most serious consequence of the coronary artery disease.
• Types of Infarcts:
• Transmural (Full thickness)
• Subendocardial (Laminar)
11.
12.
13. Brown atrophy of heart
• Lipofuscin or lipochrome – yellowish brown intracellular lipid pigment
• seen in atrophied cells of old age, hence the name ‘wear and tear
pigment’
• When seen in myocardial fibers known as brown atrophy of heart .
• On microscopy , pigment is coarse , golden brown , granular and
accumulates in the perinuclear part of the cell .
15. Hemangioma
• Lesions seen in infancy and childhood .
• Common site – skin of the face
• Types
• Capillary hemangioma
• Cavernous hemangioma
• Microscopy –well defined unencapsulated lobules consisting capillary
sized , thin walled, blood filled vessels lined with single layer of plump
endothelial cells surrounded by layer of pericytes
