[Cholesterol embolisms. The anatomical, clinical and pathogenetic aspects. Two case reports, including one case of pseudo periarteritis nodosa (author's transl)].

The authors report on two cases of cholesterol embolism, with one masquerading as polyarteritis nodosa. Cholesterol embolism is a frequent but often unrecognized complication of ulcerous athero-sclerosis. Atherosclerotic foci release a large quantity of cholesterol crystals, spontaneously or after endovascular manipulations, inducing the obstruction of small arteries, 150 to 200 microns in diameter, in various organ or tissues of the organism, such as the kidneys, the spleen, the pancreas, the digestive tract, the skin and the retina. Cutaneous, muscular, reno-vascular and visceral forms have been described, based on the distribution of the crystals. This disease, with its multiple systemic localisations and biological abnormalities may sometimes be confused with polyarteritis nodosa and constitutes the pseudo-PAN form of cholesterol embolism. In all these cases, the simplest method of diagnosis consists in the examination of the fundus and in the analysis of skin and muscle biopsies. Finally, the features of the arteriolar lesions and the lack of immunological disturbances suggest that cholesterol embolisms are form of microcrystalline arteriopathy.