Difference between revisions of "Cholesterol embolism"
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'''Cholesterol embolism''', abbreviated '''CE''', is characterized by intravascular cholesterol. | |||
'''Cholesterol embolus''' (plural '''cholesterol emboli''') and '''cholesterol embolization''' redirect here. | |||
==General== | |||
*Strong association with [[atherosclerosis]] - found in ~3% of individuals in an [[autopsy]] series of 267 older individuals (mean age ~65 years).<ref name=pmid19970827>{{cite journal | author=Flory CM | title=Arterial occlusions produced by emboli from eroded aortic atheromatous plaques | journal=Am J Pathol | year= 1945 | volume=21 | pages=549–565 | pmid=19970827 | issue=3 | pmc=1934118}}</ref> | |||
*Significant CEs are often iatrogenic. | |||
**Known complication of coronary catherization (incidence ~ 1%).<ref name=pmid12875753>{{cite journal |author=Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A |title=The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study |journal=J. Am. Coll. Cardiol. |volume=42 |issue=2 |pages=211–6 |year=2003 |month=July |pmid=12875753 |doi=10.1016/S0735-1097(03)00579-5 | url=http://linkinghub.elsevier.com/retrieve/pii/S0735109703005795}}</ref> | |||
**May complicate any vascular surgery, CABG. | |||
==Microscopic== | |||
Features:<ref name=Ref_Sternberg5_1735-6>{{Ref Sternberg5|1735-6}}</ref> | |||
*Intravascular cholesterol clefts (biconvex white spaces) - '''key feature'''. | |||
**Typically ~ 100-500 micrometers (long axis) x 50-100 micrometers (short axis). (?) | |||
*+/-Macrophages and giant cells. | |||
*+/-Eosinophils. | |||
Note: | |||
*May be associated with ischemic changes and [[necrosis]]. | |||
*Usually in the context of severe atherosclerosis. | |||
Note (trivia): | |||
*Cholesterol crystals dissolve with routine processing (paraffin embedding); this is why one talks of "cholesterol clefts". | |||
===Images=== | |||
<gallery> | |||
Image:Cholesterol_embolus_-_intermed_mag.jpg | Cholesterol embolus - intermed. mag. (WC) | |||
Image:Cholesterol_embolus_-_high_mag.jpg | Cholesterol embolus - high mag. (WC) | |||
</gallery> | |||
==See also== | |||
*[[Vascular disease]]. | |||
*[[Atherosclerosis]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Vascular disease]] | |||
Revision as of 21:11, 29 December 2013
Cholesterol embolism, abbreviated CE, is characterized by intravascular cholesterol.
Cholesterol embolus (plural cholesterol emboli) and cholesterol embolization redirect here.
General
- Strong association with atherosclerosis - found in ~3% of individuals in an autopsy series of 267 older individuals (mean age ~65 years).[1]
- Significant CEs are often iatrogenic.
- Known complication of coronary catherization (incidence ~ 1%).[2]
- May complicate any vascular surgery, CABG.
Microscopic
Features:[3]
- Intravascular cholesterol clefts (biconvex white spaces) - key feature.
- Typically ~ 100-500 micrometers (long axis) x 50-100 micrometers (short axis). (?)
- +/-Macrophages and giant cells.
- +/-Eosinophils.
Note:
- May be associated with ischemic changes and necrosis.
- Usually in the context of severe atherosclerosis.
Note (trivia):
- Cholesterol crystals dissolve with routine processing (paraffin embedding); this is why one talks of "cholesterol clefts".
Images
Cholesterol embolus - intermed. mag. (WC)
Cholesterol embolus - high mag. (WC)
See also
References
- ↑ Flory CM (1945). "Arterial occlusions produced by emboli from eroded aortic atheromatous plaques". Am J Pathol 21 (3): 549–565. PMC 1934118. PMID 19970827. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934118/.
- ↑ Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A (July 2003). "The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study". J. Am. Coll. Cardiol. 42 (2): 211–6. doi:10.1016/S0735-1097(03)00579-5. PMID 12875753. http://linkinghub.elsevier.com/retrieve/pii/S0735109703005795.
- ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 1735-6. ISBN 978-0781779425.