Table 1 The role of angiogenesis in the classification of arterial lesions compared to tumors: benign verses malignant
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] | Â |
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 Exponential More invasive displacing normal tissue ANGIOGENESIS: ANGIOGENESIS: |
Type VI : Surface defect, hematoma, thrombosis [Vermani R, Thin-cap fibrous atheroma: Vulnerable Plaque] ANGIOGENESIS MAGIFIED: 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 DEFINITIONS TO FOLLOW: |
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 | |