PMC10196535_01
(a, b) The patient was found to have multiple punctate lesions of
full-thickness necrosis every few centimeters throughout the colon, most
prominently in the ascending colon (black arrows).
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On take back, the patient was found to have multiple punctate lesions of full-thickness necrosis every few centimeters throughout the colon, most prominently in the ascending colon (Figure 1).
Macroscopic examination after formalin fixation reveals transmural
elliptical-shaped perforations were noted 12 cm from the proximal margin
with nearby areas of ulceration (black arrows).
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Upon gross examination, full-thickness transmural elliptical-shaped perforations were noted 12 cm from the proximal margin with nearby areas of ulceration (Figure 2).
Focus of ulceration with granulation tissue (black arrows).
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Microscopic examination confirmed the presence of multiple foci of ulceration with granulation tissue as well as scattered medium and small-sized vessel vasculitis, consistent with the patient's known Buerger's disease (Figures 3 and 4).
(a) Vasculitis (20x magnification), (b) arteritis (40x magnification), and
(c) venulitis (40x magnification).
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Microscopic examination confirmed the presence of multiple foci of ulceration with granulation tissue as well as scattered medium and small-sized vessel vasculitis, consistent with the patient's known Buerger's disease (Figures 3 and 4).
(a, c) Mucosal ulcer with vasculitis (black arrows, 4x and 10x magnification,
respectively). (b, d) Elastic special stain highlights the involved vessels
(black arrows, 4x and 10x magnification, respectively).
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Grocott's methianine silver special stain for fungi was negative and elastic stain highlighted the involved vessels (Figures 5 and 6).
(a) Vasculitis (arteritis) almost occluded (40x magnification) with elastin
staining shown in (b, c). Venulitis (20x magnification) with elastin
staining shown in (d).
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Grocott's methianine silver special stain for fungi was negative and elastic stain highlighted the involved vessels (Figures 5 and 6).