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Pediatría. A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis. A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association Abstract Abstract This report is the continuation of two earlier reports that defined human arterial intima and precursors of advanced atherosclerotic lesions in humans. This report describes the characteristic components and pathogenic mechanisms of the various advanced atherosclerotic lesions. These, with the earlier definitions of precursor lesions, led to the histological classification of human atherosclerotic lesions found in the second part of this report. Key Words: This report is the third and last in a series. The descriptions and definitions in this report are based on the histological and histochemical composition as well as the structure and ultrastructure of both the cell and matrix components of the lesions.
Human lesions can be obtained for study as specimens during therapeutic interventions or at autopsy. Atherosclerotic Lesion Types Advanced by Histology. Atherosclerosis Pathology. The early lesions consist of 2 nonatherosclerotic intimal lesions referred to as adaptive intimal thickening and intimal xanthoma ("fatty streak" in the AHA classification) (see the image below). Intimal xanthoma denotes a lesion rich in foamy macrophages without extracelullar lipid pools. Adaptive intimal thickening is present from birth and grow in areas of low shear stress, and are consist mainly of smooth muscle cells in a proteoglycan rich matrix. Observations from experimental models and autopsy studies in young human subjects suggest that monocyte adherence to the endothelial surface and transmigration into the intima occur as the earliest events in the development of atherosclerotic lesions.
Adaptive intimal thickening is characterized by retention of modified lipoproteins within the proteoglycan rich matrix in the intima. Pathologic Intimal Thickening Progression to Complex Atherosclerotic Lesions The following generally describes the progression of atherosclerotic lesions. Atherosclerosis Pathology. The early lesions consist of 2 nonatherosclerotic intimal lesions referred to as adaptive intimal thickening and intimal xanthoma ("fatty streak" in the AHA classification) (see the image below). Intimal xanthoma denotes a lesion rich in foamy macrophages without extracelullar lipid pools. Adaptive intimal thickening is present from birth and grow in areas of low shear stress, and are consist mainly of smooth muscle cells in a proteoglycan rich matrix.
Observations from experimental models and autopsy studies in young human subjects suggest that monocyte adherence to the endothelial surface and transmigration into the intima occur as the earliest events in the development of atherosclerotic lesions. Adaptive intimal thickening is characterized by retention of modified lipoproteins within the proteoglycan rich matrix in the intima. Pathologic Intimal Thickening Progression to Complex Atherosclerotic Lesions The following generally describes the progression of atherosclerotic lesions.
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