[Morphogenesis of media calcinosis in Mönckeberg disease. Light microscopy, scanning electron microscopy and roentgen...

In contrast to granular mediacalcinosis of the aorta, Mönckeberg's disease is characterized by the occurrence of sheet-like calcification. It is usually said that the pathogenesis of this calcification is unknown.

To obtain some insight into the mechanism leading to this calcification, we performed light microscopic, scanning electron microscopic and X-ray microanalysis investigations on femoral arteries from autopsies.

By light microscopy preferentially sheet-like calcifications of different size appeared. In the alizarin red S stain in the neighborhood of these compact structures calcified globules were observed. By SEM in the neighborhood of the compact areas calcified granules were found; the compact structures themselves consisted of granules sticking one onto the other. X-ray microanalysis exhibited high contents of calcium and phosphorus in the compact calcifications; they also showed a minor content of magnesium. Isolated granules inside the compact calcifications showed a nearly identical composition, while granules outside in the surrounding media consisted preferentially from calcium and phosphorus, but they exhibited a slight higher magnesium content.

It is concluded that Mönckeberg's media calcification is due to dystrophic calcification. Calcified matrix vesicles from necrotic cells, as it is assumed for the pathogenesis of the calcification of arteriosclerotic plaques (31), are interpreted as precursors of the solid calcifications which may develop by confluence and sticking one onto the other of calcified globules.