Cellular arteriolar nodules. Their presence in heart, pancreas, and kidneys of patients with malignant nephrosclerosis.

Angioblastic-appearing nodules of small arteries of heart, pancreas, and kidneys were found during microscopic study of autopsy specimens form subjects with hypertension that had responded poorly to treatment. These vascular lesions were noted in three of 15 subjects studied; they were associated with a proliferative arteriolosclerosis that was most severe in the kidney and the pancreas, but was occasionally found in the arterioles of the heart. Two of these three subjects had received treatment with dialysis; one had not. The nodules originated concentrically along a segment of small artery and consisted of a mass of mesenchymal cells and capillary-sized blood channels. There were fragmentation and focal loss of the internal elastic lamina at their points of origin, and vessel-wall necrosis in an occasional lesion. Many of these nodules appeared identical to plexiform lesions of the lung and to cellular types of Charcot-Bouchard aneurysms of the CNS.