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Thrombosis
Pathological process of formation ofthrombus
in circulation from the constituents of
flowing blood.
Endothelial Injury
• Procoagulant activity - upregulation
• Anticoagulant activity - downregulation
Alterations in Normal Blood Flow
Hypercoagulability - an abnormally high
tendency of the blood to clot, and is typically caused by
alterations in coagulation factors
• Particularly important role in venous
thrombosis
Morphologic Features
• Gross-
• thrombi may be of various shapes, sizes and composition .
Arterial thrombi - white
• venous thrombi are red and occlusive.
• Mixed or laminated thrombi are also common and consist of
alternate white and red layers called lines of Zahn.
• Red thrombi are soft, red and gelatinous whereas white
thrombi are firm and pale.
• Microscopy-
• The lines of Zahn are formed by alternate layers of light-
staining aggregated platelets admixed with fibrin meshwork
and dark-staining layer of red cells.
• Red (venous) thrombi have more abundant red cells,
leucocytes and platelets entrapped in fibrin meshwork. Thus,
red thrombi closely resemble blood clots in vitro
Fate of the Thrombus
• Four events:------
• Propagation- Thrombi accumulate additional
platelets and fibrin
• Embolization - Thrombi dislodge and travel to
other sites
• Dissolution - fibrinolysis --rapid shrinkage and
total disappearance
• Organization and recanalization

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Thrombosis.pptx

  • 2. Pathological process of formation ofthrombus in circulation from the constituents of flowing blood.
  • 3.
  • 4. Endothelial Injury • Procoagulant activity - upregulation • Anticoagulant activity - downregulation
  • 6.
  • 7. Hypercoagulability - an abnormally high tendency of the blood to clot, and is typically caused by alterations in coagulation factors • Particularly important role in venous thrombosis
  • 8.
  • 9.
  • 10. Morphologic Features • Gross- • thrombi may be of various shapes, sizes and composition . Arterial thrombi - white • venous thrombi are red and occlusive. • Mixed or laminated thrombi are also common and consist of alternate white and red layers called lines of Zahn. • Red thrombi are soft, red and gelatinous whereas white thrombi are firm and pale. • Microscopy- • The lines of Zahn are formed by alternate layers of light- staining aggregated platelets admixed with fibrin meshwork and dark-staining layer of red cells. • Red (venous) thrombi have more abundant red cells, leucocytes and platelets entrapped in fibrin meshwork. Thus, red thrombi closely resemble blood clots in vitro
  • 11.
  • 12.
  • 13.
  • 14. Fate of the Thrombus • Four events:------ • Propagation- Thrombi accumulate additional platelets and fibrin • Embolization - Thrombi dislodge and travel to other sites • Dissolution - fibrinolysis --rapid shrinkage and total disappearance • Organization and recanalization