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 6

Segmental arterial mediolysis injurious phase. The large black arrow points to a focus of transmural mediolysis with foamy contents that has caused a bulging of the arterial wall bordered inwardly by an intact internal elastica and outwardly by a linear deposit of fibrin. The bulge contents are alcian blue negative. The small black arrow points to a similarly bulging media, and the red arrow to a beginning gap created by the incipient medial loss of the watery mediolytic contents thru an intima depleted of an internal elastica. Movat stain ×100 (adapted with permission from the American Journal of Surgical Pathology 13(7) copyright l989, Lippincott, Williams and Williams).