Thromboangiitis obliterans

• aka Buerger disease

• young (usually < 35 years old) smokers (smokers is the ding-dong association)

• segmental, thrombosing, acute or chronic inflammation of medium to small arteries

• this often involves the extremities

Pathogenesis

• direct toxicity to endothelium

• idiosyncratic immune reaction?

Pathology

• segmental acute and chronic vasculitis

• affects medium-sized arteries, predominantly toward the extremities: radial, tibial arteries

• thrombosis with microabscesses

Histology

• acute: thrombus and neutrophils

• chronic: thrombi undergo organization and fibroblasts grow into them. organized thrombi result

Clinical features

• chronic ulceration of digits

• later: gangrene of fingers and toes. serial amputations are sometimes required

• cure: quit smoking

Category: Medical Subject Notes , Pathology Notes