Cholesterol embolism
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Cholesterol embolism | |
---|---|
Diagnosis in short | |
Cholesterol embolism. H&E stain. | |
| |
LM | intravascular cholesterol clefts (biconvex white spaces), +/-macrophages and giant cells, +/-eosinophils |
Site | blood vessels - arteries |
| |
Associated Dx | atherosclerosis |
Clinical history | +/-cardiovascular intervention, +/-cardiovascular disease, +/-risk factors for cardiovascular disease (age, hypertension, hypercholesterolemia, diabetes, smoking) |
Prevalence | not typically biopsied, common in eldery |
Prognosis | dependent on extent |
Clin. DDx | vasculitis |
Cholesterol embolism, abbreviated CE, is characterized by intravascular cholesterol.
Cholesterol embolus (plural cholesterol emboli) and cholesterol embolization redirect here.
General
- Strong association with atherosclerosis - found in ~3% of individuals in an autopsy series of 267 older individuals (mean age ~65 years).[1]
- Significant CEs are often iatrogenic.
Microscopic
Features:[3]
- Intravascular cholesterol clefts (biconvex white spaces) - key feature.
- Typically ~ 100-500 micrometers (long axis) x 50-100 micrometers (short axis). (?)
- +/-Macrophages and giant cells.
- +/-Eosinophils.
Note:
- May be associated with ischemic changes and necrosis.
- Usually in the context of severe atherosclerosis.
Note (trivia):
- Cholesterol crystals dissolve with routine processing (paraffin embedding); this is why one talks of "cholesterol clefts".
Images
See also
References
- ↑ Flory CM (1945). "Arterial occlusions produced by emboli from eroded aortic atheromatous plaques". Am J Pathol 21 (3): 549–565. PMC 1934118. PMID 19970827. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934118/.
- ↑ Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A (July 2003). "The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study". J. Am. Coll. Cardiol. 42 (2): 211–6. doi:10.1016/S0735-1097(03)00579-5. PMID 12875753. http://linkinghub.elsevier.com/retrieve/pii/S0735109703005795.
- ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 1735-6. ISBN 978-0781779425.