Which histologic findings are characteristic of thromboangiitis obliterans (TAO) (Buerger disease)?

Updated: Jul 27, 2020
  • Author: Naiem Nassiri, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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In its acute phase, TAO is characterized by highly cellular, segmental, occlusive, inflammatory thrombi, with minimal inflammation in the walls of affected blood vessels. Secondary spread from the affected small and medium-sized arteries to contiguous veins and nerves is often observed. Microscopically, the polymorphonuclear leukocyte (PMN)-predominant inflammatory cellular aggregate may form microabscesses and multinucleated giant cells.

In the subacute phase, intraluminal thrombosis progressively organizes, but it may defer to vascular recanalization. [12] The end-stage phase of TAO is characterized by mature thrombus and vascular fibrosis.

In all three stages of the disease, the integrity of the normal structure of the vessel wall, including the internal elastic lamina, is maintained. This maintenance of structural integrity distinguishes TAO from arteriosclerosis and from other types of systemic vasculitis, in which disruption of the internal elastic lamina and the media can be extensive.

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