Kakiuchi H, Oinuma T, Yamada T
Second Department of Pathology, Nihon University School of Medicine.
Nihon Ronen Igakkai Zasshi. 1995 Jul;32(7):503-10. doi: 10.3143/geriatrics.32.503.
Atherosclerotic plaque with central depression (depressed lesion) was firstly proposed in our previous report as one of the morphological features of regressed lesions, which was characterized by the presence of isolated, well defined lesions with a centrally depressed area and smooth surface. They were obviously different from atherosclerotic plaques with ulceration (ulcerated plaques) in elderly autopsy cases. In this study, 30 ulcerated plaques obtained from specimens of the elderly aortas were histologically and immunohistochemically investigated to clarify the morphogenesis of the depressed lesion and its correlation to the ulcerated plaque. These depressed lesions were divided into 4 groups according to their derivation; (a) fused lesion of multiple fibrous plaques, (b) regressing lesion of plaques, (c) healed ulcerated plaques, and (d) mixed type of these lesions. Regeneration of endothelial cell was noted in the peripheral zone of ulcerated plaques, and collagen type IV was also increased in the stroma of these ulcerated plaques. These were healed ulcerated plaques. The ulcerated plaques with complete restoration of endothelial cells on the ulcerated surface may become atherosclerotic plaques with central depression. These lesions are one of the histological features of regression in advanced atherosclerosis.
在我们之前的报告中首次提出了具有中央凹陷（凹陷性病变）的动脉粥样硬化斑块作为消退性病变的形态学特征之一，其特征为存在孤立的、边界清晰的病变，中央有凹陷区域且表面光滑。它们与老年尸检病例中具有溃疡形成的动脉粥样硬化斑块（溃疡斑块）明显不同。在本研究中，对从老年主动脉标本中获取的30个溃疡斑块进行了组织学和免疫组织化学研究，以阐明凹陷性病变的形态发生及其与溃疡斑块的相关性。这些凹陷性病变根据其来源分为4组：（a）多个纤维斑块的融合病变，（b）斑块的消退性病变，（c）愈合的溃疡斑块，以及（d）这些病变的混合型。在溃疡斑块的周边区域观察到内皮细胞再生，这些溃疡斑块的基质中IV型胶原也增加。这些是愈合的溃疡斑块。溃疡表面内皮细胞完全恢复的溃疡斑块可能会变成具有中央凹陷的动脉粥样硬化斑块。这些病变是晚期动脉粥样硬化消退的组织学特征之一。
