Blood Vessels

Front 1

Diagnosis?

Back 1

Giant cell (temporal) arteritis.

Temporal artery shows thickened, nodular and tender segment.

Front 2

Back 2

Arrow shows focal destruction of internal elastic membrane and intimal thickening characteristic of long standing or healed arteritis.

Stain is Elastin stain.

Front 3

Back 3

Giant cell arteritis.

Front 4

Back 4

Takayasu arteritis.

Front 5

Back 5

Takayasu arteritis.

Gross appearance of cross section of carotid artery.

Shows marked intimal thickening and adventitial fibrosis with minimal residual lumen.

Front 6

Back 6

Polyarteritis Nodosa.

Segmental fibrinoid necrosis and thrombotic occlusion of lumen of this small artery.

Front 7

Back 7

Microscopic Polyangitis (leukocytoclastic vasculitis).

Fragmentation of neutrophils in and around blood vessel walls( nuclear dust).

Front 8

Back 8

Granulomatosis with Polyangitis.

Also Wegner's granulomatosis.

Granulomatous inflammation showing giant cells.

Front 9

Back 9

Wegner's granulomatosis.

Lung of patient with fatal granulomatosis with Polyangitis demonstrating large, nodular, centrally cavitating lesions.

Front 10

Back 10

Thromboangiitis obliterans (Buerger disease)

Lumen is occluded by thrombus containing microabscesses composed of neutrophils , vessel wall is infiltrated with leukocytes.

Front 11

Back 11

RAYNAUD PHENOMENON

A) Sharply demarcated pallor of distal arteries due to closure of distal arteries.

B) Cyanosis of the fingertips.

Front 12

Back 12

Pyogenic granuloma of lip.

These are capillary hemangiomas.

Front 13

Back 13

Hemangioma of the tongue.

Front 14

Back 14

Juvenile capillary hemangioma.

Strawberry type hemangioma.

Rapidly grow for few months but then fade by 1-3 yrs of age and completely regress by age of 7.

Front 15

Back 15

Cavernous Hemangioma.

Large cavernous blood filled vascular spaces separated by thick connective tissue stroma.

Front 16

Back 16

Bacillary angiomatosis.

A) characteristic cutaneous lesion.

B) acute neutrophilic inflammation with capillary proliferation

Warthin-starry stain demonstrates cluster of tangled bacilli(black).

Front 17

Back 17

Kaposi Sarcoma.

Coalescent red-purple macules and plaques of the skin.

Front 18

Back 18

Kaposi Sarcoma.

Nodular stage of it.

Sheets of proliferating spindle cells.

Front 19

Back 19

Angiosarcoma.

Front 20

Back 20

Angiosarcoma.

Moderately differentiated angiosarcoma with dense clumps of atypical cells lining distinct vascular lumens.

Front 21

Back 21

Angiosarcoma.

IHC staining for endothelial cell marker CD31 demonstrating endothelial nature of tumor cells.

Front 22

Back 22

Restenosis after angioplasty and stenting.

Movat stain used in B which stains collagen fibres.

Front 23

Back 23

Intimal hyperplasia at distal anastamosis of a synthetic femoral-popliteal graft.

A) Angiogram shows constriction.

B) arrow shows Gore-Tex graft with prominent intimal proliferation and very small residual lumen"*".