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KMID : 0191120000150010044
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Journal of Korean Medical Science
2000 Volume.15 No. 1 p.44 ~ p.48
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Morphologic change of the internal elastic lamina in Buerger´s disease
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Kim EJ
Cho BS/Lee TS/Kim SJ/Seo JW
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Abstract
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Morphologic features and pathogenesis of arterial changes occurring in Buerger´s disease
(thromboangiitis obliterans) are still controversial. This study describes histopathologic
features of medium sized arteries from patients with Buerger´s disease, particularly of the
internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen
segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger´s
disease were analyzed by histopathological and immunohistochemical methods. The most
characteristic features were total luminal obliteration, together with a varying degree
of recanalization and deposition of hemosiderin pigments. Detailed analysis, however,
showed marked undulation and multiplication of the internal elastic lamina (100%) associated
with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration
along the internal elastic lamina was seen in 71% and was associated with localized edema.
Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate
fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific
and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina
associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of
the thrombotic occlusion and organization of medium-sized arteries in Buerger´s disease.
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