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Intimal thickening of peripheral pulmonary vein: Analysis of 139 consecutive autopsy cases

M Sageshima¹, H Masuda², K Kawamura²

¹Department of Laboratory Medicine, Akita University School of Medicine, Akita, Japan.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology

|May 21, 2015

Abstract:

Intimal thickening of the peripheral pulmonary veins collected from 139 autopsy cases (ages ranging from 1 to 96 years) was examined morphologically. The peripheral pulmonary veins were classified as medium-sized veins, small veins, and postcapillary venules. Intimal thickening, graded into four levels from (-) to (+++), increased with age in all three types of the peripheral veins. The severity of intimal thickening was age-dependent. In mediumsized veins, smooth muscle cells were recognized in the intima of all ages, though the amount of collagen fiber in the intima increased with age. In small veins, slight fibrosis and a few smooth muscle cells were seen in the subendothelial regions in autopsy cases up to 20 years of age. Thereafter, collagenous thickening was common. In postcapillary venules, edematous or dense collagenous thickening was a common feature of the intimal thickening in the autopsy cases over 20 years old. In those between 1 and 20 years of age who succumbed to left ventricular failure, intimal thickening was more severe than in those of the same age range in this study. The pathogenesis and the clinical significance of age-associated intimal thickening of the pulmonary veins has not been elucidated yet.

Insights

Pulmonary vein intimal thickening increases with age in all vessel types. This age-dependent change, characterized by smooth muscle cells and collagen, progresses differently across medium veins, small veins, and venules.

Area of Science:

Cardiovascular Pathology
Pulmonary Vascular Disease

Background:

Intimal thickening in peripheral pulmonary veins is a poorly understood phenomenon.
Age is a known factor influencing vascular structure.

Purpose of the Study:

To investigate the morphological changes of intimal thickening in peripheral pulmonary veins across a wide age range.
To characterize the age-dependent progression and histological features of intimal thickening.

Main Methods:

Morphological examination of peripheral pulmonary veins from 139 autopsy cases (ages 1-96).
Classification of veins into medium-sized veins, small veins, and postcapillary venules.
Grading of intimal thickening severity from (-) to (+++).

Main Results:

Intimal thickening severity significantly increased with age in all examined peripheral pulmonary vein types.
Medium-sized veins showed increasing collagen with age, while small veins exhibited fibrosis and smooth muscle cells, progressing to collagenous thickening post-20 years.
Postcapillary venules commonly displayed edematous or dense collagenous thickening in individuals over 20 years old.

Conclusions:

Age-associated intimal thickening is a common finding in peripheral pulmonary veins.
The specific patterns of intimal thickening vary by vessel type and age.
Further research is needed to elucidate the pathogenesis and clinical significance of these age-related vascular changes.

Read full analysis

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