Figure 4. A, Crescent-shaped atherosclerotic plaque in the proximal LAD coronary artery of a 53-year-old white male.
Figure 4. A, Crescent-shaped atherosclerotic plaque in the proximal LAD coronary artery of a 53-year-old white male.
Figure 4. A, Crescent-shaped atherosclerotic plaque in the proximal LAD coronary artery of a 53-year-old white male.

Figure 4

A, Crescent-shaped atherosclerotic plaque in the proximal LAD coronary artery of a 53-year-old white male. Red and blue injection mass has mixed in the lumen (asterisk). Note the major part of the plaque is composed of whitish material (fat arrows), and microscopic examination shows this white material to be the necrotic core. The fibrous cap is made up of what appears to be clear or transparent tissue (thin arrows) and varies in thickness from one side of the plaque to the other. The fibrous cap is quite thin at the plaque shoulder near the bottom of the photograph (open arrow). B, High-power view of the plaque shown in A. The necrotic core is identified by a black asterisk, and the arterial lumen by a white asterisk. The fibrous cap has structure similar to that shown in Figures 3A and 3B, is adjacent to the lumen. The fibrous tissue (arrows) between the lumen and the necrotic core has undergone partial degeneration and necrosis. MSB stain. C, SMC actin stain of a fibrous plaque surrounding a necrotic core (asterisk) from another patient. The tissue adjacent to the necrotic core has undergone degeneration with loss of SMCs, but the basic fibrous structure remains (Bracket 1). The next layer outward from the necrotic core (Bracket 2), shows the SMCs are still apparently viable and stain appropriately with the SMC actin stain, but many are lipid-laden (long arrows), of different size, with several small lipid lakes and with early degeneration of tissue at the right side of the photograph (open arrows). Beyond this second layer is a layer of cellular fibrous tissue (Bracket 3) composed of viable-appearing SMCs, and only occasional small lipid-laden SMCs (short arrows).

From: Chapter 2, The Smooth Muscle Cell. The Pivot in Atherosclerosis

Cover of Inflammatory Atherosclerosis
Inflammatory Atherosclerosis: Characteristics of the Injurious Agent.
Frink RJ.
Sacramento (CA): Heart Research Foundation; 2002.
Copyright © 2002, Richard J Frink.

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