Vascular thrombus
Vascular thrombus is an uncommon pathology specimen that may be from an artery or vein.
Venous thrombus and arterial thrombus redirect here.
General
- Uncommonly comes to pathology.
Risk factors - think Virchow's triad:
- Stasis, e.g. atrial fibrillation.
- Hypercoagulable states, e.g. cancer - see risks factors venous thromboembolism.
- Endothelial injury.
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
Laminated thrombus - low mag. (WC)
Laminated thrombus - high mag. (WC)
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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
- ↑ 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.