Vascular thrombus

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Vascular thrombus is an uncommon pathology specimen that may be from an artery or vein.

Venous thrombus and arterial thrombus redirect here.

General

Risk factors - think Virchow's triad:

Gross

See pulmonary embolism.

Features:

  • Dull appearance.
  • Laminations.

Microscopic

Features:

  • Layers consisting of platelets and fibrin.
    • Classically alternating with layers of RBCs - known as Lines of Zahn.[1]

Note:

  • Multiple laminations (layers), in general, suggest that clot was formed in a dynamic environment, i.e. in the context of blood flow.

DDx:

  • Tumour embolus - malignant cells.
  • Thromboembolus - may require clinical history.
  • Fat embolism.
  • Amniotic fluid embolus - in the context of pregnancy/postpartum.
  • Foreign body.

Images

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BLOOD CLOT, LEFT ILIAC ARTERY, THROMBECTOMY:
- THROMBUS.
- NEGATIVE FOR MALIGNANCY.
BLOOD CLOT, LEFT ARM - BRACHIAL ARTERY, THROMBECTOMY/EMBOLECTOMY:
- THROMBUS.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show layers of red blood cells alternating with fibrin and white blood cells (Lines of Zahn).

See also

References

  1. Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 124. ISBN 978-1416031215.