Thromboangiitis obliterans (Buerger’s Disease) Proc. 12th Conf. Int. Soc. Gcograph. Path., Zurich, September 1975 Path. Microbiol. 43: 151-156 (67-72) (1975)

Early Inflammatory Changes in Thromboangiitis obliterans H . J. L eu institute of Pathology, University of Zurich, Zurich

Key Words. Thromboangiitis obliterans • Buerger's disease • Morphology • Early inflammatory changes

Histological observations of early inflammatory lesions in thrombo­ angiitis obliterans are rare, because adequate examination material cannot be obtained until major surgery becomes necessary. In amputated limbs the majority of arteries show advanced stages of the inflammatory proc­ ess. The careful examination of macroscopically unaffected arteries, how­ ever, may reveal fresh inflammatory lesions apart from the well-known advanced alterations (fig. 1).

Fig. 1. Advanced lesion in thromboangiitis obliterans. Lumen occluded by an organized thrombus. Internal elastic lamella partly destroyed. Fibrosis of the adventitia, x 30. Fig. 2. Early inflammatory lesion in thromboangiitis obliterans. Accumulation of inflammatory cells in the subendothelial layer. Endothelium partly intact, partly desquamated, x 300. Fig. 3. Early inflammatory lesion in thromboangiitis obliterans. Endothelium destroyed. Palisading and proliferation of intimal fibroblasts, x 300. Fig. 4. Early inflammatory lesion in thromboangiitis obliterans. Fibrinoid necro­ sis of the intima. x 300. Fig. 5. Involvement of the media in thromboangiitis obliterans. Dense lympho­ cyte infiltrates with giant cells. Lumen occluded by an organized thrombus, x 30. Fig. 6. Migrating phlebitis in a case of thromboangiitis obliterans. Lymphocyte infiltrates in media and intima. Proliferation and palisading of intimal fibroblasts. Granulomas with giant cells in the intima. Lumen occluded, x 80.

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For figures 1-6, see pages 152-154.

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For legends to figures 1 and 2, see page 151.

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