J Korean Med Sci.  2000 Feb;15(1):44-48. 10.3346/jkms.2000.15.1.44.

Morphologic change of the internal elastic lamina in Buerger's disease

• Kim EJ
• Cho BS
• Lee TS
• Kim SJ
• Seo JW

• KMID: 1731232
• DOI: http://doi.org/10.3346/jkms.2000.15.1.44

Abstract

Morphologic features and pathogenesis of arterial changes occurring in Buerger's disease (thromboangiitis obliterans) are still controversial. This study describes histopathologic features of medium sized arteries from patients with Buerger's disease, particularly of the internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger's disease were analyzed by histopathological and immunohistochemical methods. The most characteristic features were total luminal obliteration, together with a varying degree of recanalization and deposition of hemosiderin pigments. Detailed analysis, however, showed marked undulation and multiplication of the internal elastic lamina (100%) associated with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration along the internal elastic lamina was seen in 71% and was associated with localized edema. Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of the thrombotic occlusion and organization of medium-sized arteries in Buerger's disease.

Keyword

Thromboangiitis Obliterans; Internal Elastic Lamina; T-Lymphocytes

MeSH Terms

Adult
B-Lymphocytes/pathology
Elastic Tissue/pathology
Elastic Tissue/immunology
Female
Femoral Artery/pathology*
Femoral Artery/immunology
Femoral Artery/anatomy & histology
Fibrosis
Human
Male
Middle Age
Popliteal Artery/pathology*
Popliteal Artery/immunology
Popliteal Artery/anatomy & histology
T-Lymphocytes/pathology
Thromboangiitis Obliterans/pathology*
Thromboangiitis Obliterans/immunology