[Pathomorphology and morphogenesis of obliterating endarteritis]

The author has examined the pathomorphological arterial changes in 37 amputated legs of patients with obliterating endarteritis. He has studied the principal morphogenetic stages of the disease. Obliterating endarteritis was shown to have an inflammatory origin. Its morphogenesis was found to be characterized by the main stages appearing in the following order: fibrinoid swelling and necrosis of the intima; lymphoid-macrophagal infiltration of the intima (sometimes with presence of giant multinuclear cells) involving the media; intimal hyperplasia and thrombosis occluding the vascular lumen; sclerosis of the vascular wall. At different levels of the amputated limb one could find different stages of the pathologic process due to the undulating character of the disease. The distal sites of the major arteries (mainly located in the lower third of the crus) were the first to undergo changes, and the disease progressed proximally.