PMC6503200_01
The clinical manifestation of the patient with diagnosis of Buerger's disease from early January 2018 until late May 2018.
IMCRJ-12-119-g0001.jpg
PMC6503200_01_IMCRJ-12-119-g0001.jpg
F0001
Also, superficial thrombophlebitis was observed on the left calf (Figure 1A,B). In late January 2018, the patient reported again with gangrene and an ulcer of the left big toe, along with burning pain at rest (Figure 1C). He was recommended for below-knee amputation after his cold and cyanotic foot was observed (Figure 1D). After a week, the color of the foot changed to purple, and the foot became warmer (Figure 1E). The gangrene started to progress (Figure 1F), but was limited to the derma of the forefoot skin (Figure 1G).
Computed tomography angiography of the patient with diagnosis of Buerger's disease. Occlusion of both superficial femoral arteries with multiple occlusions of left posterior tibial artery without stenosis in the aortoiliac and iliofemoral was observed.
IMCRJ-12-119-g0002.jpg
PMC6503200_01_IMCRJ-12-119-g0002.jpg
F0002
The patient underwent computed tomography (CT) angiography of his left limb (Figure 2).
H&E staining; x10 objective lens. The biopsy obtained around the ulcer of the amputated limb of a patient with diagnosis of Buerger's disease
IMCRJ-12-119-g0003.jpg
PMC6503200_01_IMCRJ-12-119-g0003.jpg
F0003
Both acute and chronic inflammation in the thrombus and the layers of the vessel walls were observed (Figure 3).
The biopsy obtained from the sural nerve of the amputated limb of a patient with diagnosis of Buerger's disease.. Notes: H&E statining, x5 objective lens, perivascular inflammation in vasa nervorum (A-C); H&E staining, 40x objective lens, infiltration of inflammatory cells and in vasa nervorum and proliferation of endothelial cells of vasa nervorum (D-F)
IMCRJ-12-119-g0004.jpg
PMC6503200_01_IMCRJ-12-119-g0004.jpg
F0004