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 21

Segmental arterial mediolysis reparative phase. The tear space between the outer media and adventitia is widely expanded by mature granulation tissue containing a hematoma (blue arrow) and a dissecting aneurysm (black arrow). The white arrows point to foci of mature granulation tissue in the outer media a clue to SAM’s genesis of the dissection. Movat stain ×15 (adapted with permission from the International Journal of Surgical Pathology 15(2) copyright 2007, Sage Publications).