Segmental Arterial Mediolysis: A Multiguised Vasospastic Arteriopathy with Collateral Mesangial Cell Hyperplasia and Cardiac Toxicity Generated by Norepinephrine and Hyperdense Adrenoceptors Alone or by Crosstalk with Other Pressor Agents

Figure 14

Segmental arterial mediolysis reparative phase. Early reparative change in media and intima. The red arrow points to young granulation tissue filling and expanding a focus of transmural mediolysis and extending thru a fragmented internal elastica to form a broad intimal plaque severely narrowing an arterial lumen (blue arrow) already compromised by a recent thrombus. The black arrow points to a markedly outwardly expanded fibrin-lined adventitia outlining an edematous fibrin stranded zone of mediolysis that shows at light blue arrow another focus of granulation tissue. Movat stain ×100 (adapted from the Journal of Cardiovascular Disease and Diagnosis 2015.32, online publication).