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Table 1 The role of angiogenesis in the classification of arterial lesions compared to tumors: benign verses malignant

From: Vasa vasorum in plaque angiogenesis, metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: a malignant transformation

ATHEROMA (Benign) ADENOMA (Benign)
Growth locally Growth locally
Types I and II : (Initial lesion – fatty streak) Lesion remains less 3–4 mm if no angiogenesis
Type III : (Isolated extracellular lipid pools) Preatheroma (Tissue damage and disorder) [Virmani R, Pathological intimal thickening]  
Type IV : (Formation of lipid core) Atheroma (Massive structural damage to intima). ANGIOGENESIS INDUCED: [Virmani R, fibrous cap atheroma] ANGIOGENESIS INDUCED:
Malignant Transformation ANGIOGENESIS Malignant Transformation ANGIOGENESIS
Type V : Fibroatheroma (SMC) Proliferation – Migration Fibromuscular tissue layers produced Thickening of intima and media ANGIOGENESIS Development of protective fibrous cap [Virmani R, thick-cap fibrous atheroma] Now rapid cell growth
More invasive displacing normal tissue
Type VI : Surface defect, hematoma, thrombosis [Vermani R, Thin-cap fibrous atheroma: Vulnerable Plaque]
Intraplaque hemorrhage: (IPH):
Contributing to unstable vulnerable plaque rupture and thrombosis.
Cholesterol emboli to: Extremities (PAD), Kidney, Brain. (TIAs), Coronaries
Bleeding and ulceration
Metastasis to Liver, Lung Brain
Type VII : Calcification predominates. ANGIOGENESIS: Recapitulated in distant organs
Type VIII : Fibrous tissue changes predominate. Type V to type VIII: Recapitulation of lesions: Repeated layering of eccentric atheroma. ANGIOGENESIS: Recapitulated in distant organs
1. ATHEROMA: G. athere, gruel or porridge + oma, tumor.
2. TUMOR: L. a swelling. Syn. neoplasm.
3. NEOPLASM: G. neos, new. plasma, thing formed.. Syn. New growth.
4. BENIGN: Fr. Fr.L., benignus, kind. Denoting the mild character of an illness or the non malignant character of a neoplasm.
5. MALIGNANT: L. maligno p.(ant). To do anything maliciously. Resistant to treatment; occurring in sever form, and frequently fatal; tending to become worse. In reference to neoplasm, having the property of being locally invasive and destructive with growth and metastasis.
6. ATHEROSCLEROSIS: G. athere, gruel or porridge + skleros, hard. (A malignant form of atheroma implying the presence of a proinflammatory, prothrombotic, profibrotic, pro oxidative – redox stress, and proangiogenic state).
SOURCE: Steadman's Medical Dictionary. 26th Edition. 1995 Williams and Wilkins. Baltimore, MD. USA