Pathology and pathogenesis of Buerger's disease

Since Buerger's disease, which is also called 'thromboangiitis obliterans', was proposed in 1908 (Buerger, Am J Med Soc 1908;136:567), more cases have been reported from the United States, Europe, and especially from the Orient. However the pathogenesis of this disease remains unclarified, and its acceptance as a specific disease entity has been disputed (Gore and Burrows, Am J Clin Pathol 1958;29:319; Wessler et al., N Engl J Med 1960;262:1149). We histologically examined the surgically resected arterial specimens from 113 cases, 109 males and four females, clinically diagnosed as Buerger's disease in 1975-1976 and reported the results in 1978 (Kurozumi and Tanaka, Vasc Surg 1978;12:63) and proposed that the term 'Buerger's disease' should be replaced by 'Buerger's syndrome'. We reexamined the above-mentioned cases and will report the pathology and propose the possible pathogenesis of Buerger's disease.