description of gross and microscopic morphology of an atherosclerotic lesion, includes fatty streak, simple plaque and fatty plaque.

1. By- Sneha A (MBBS UG)
MORPHOLOGY

3.  Distribution: infrarenal abdominal aorta >
coronary arteries > popliteal arteries >
internal carotid arteries > the vessels of the
circle ofWillis.
 Spared: upper extremities, renal, mesenteric
(except ostia).

5.  Stages:
 Fatty streak
 Simple plaque
 Complicated plaque

6.  Lipid deposits in intima.
 Yellow, slightly raised.
 Fatty streaks can appear in the
aortas of infants younger than 1
year and are present in virtually
all children older than 10 years.
 Spot (1mm) -> Streak
(1x10mm).
 The relationship of fatty streaks
to atherosclerotic plaques
 Possible precursor of atheroma.

7.  Intimal thickening and lipid accumulation
 white to yellow raised lesions ranging from
0.3 to 1.5 cm in diameter.

8.  Rupture, ulceration, or
erosion of the luminal
surface
 Plaque superimposed with
thrombus
 Lesions having undergone
calcification
 Lesions progressing to
form aneurism.

11. NORMAL (HAPPY) BLOOD
VESSEL
ATHEROSCLEROTIC BLOOD
VESSELS

12.  3 parts
 Fibrous cap
 Shoulder of cells
 Central necrotic core
3.NECROTIC CENTER
2.SHOULDER OF
CELLS
1.FIBROUS
CAPSULE

13.  Lies just beneath the
endothelium.
 Composed of smooth
muscle cells and
relatively dense
collagen.

14.  Lies just beneath the
fibrous cap,
 Consists of foamy
macrophages,
inflammatory cells and
proliferated and
recruited smooth
muscle cells

15.  Is the soft center of the
plaque.
 Composed of
intracellular and extra
cellular lipid.
 Some times necrosis
may be seen

16.  The periphery of
the plaque shows
neo-
vascularisation.

19. GROSS
 3 stages
 Fatty streak
 Simple plaque
 Complicated
plaque
MICROSCOPY
 3 regions of
plaque
 Fibrous cap
 Shoulder of cells
 Necrotic core