Buerger’s disease in a 19-year-old woman

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Buerger’s disease in a 19-year-old woman Masahiro Matsushita, MD, Akihiko Kuzuya, MD, Masayoshi Kobayashi, MD, Naomichi Nishikimi, MD, Masafumi Ito, MD, Yasuhiro Oba, MD, Takashi Yano, MD, Kimihiro Komori, MD Journal of Vascular Surgery Volume 38, Issue 1, Pages 175-179 (July 2003) DOI: 10.1016/S0741-5214(03)00128-9

Fig 1 Angiographic findings. A, Angiogram of the left lower extremity. Flow in the popliteal artery is abruptly cut off above the knee, and only the peroneal artery is visualized at the calf (arrow). B, Angiogram of the left upper extremity. The brachial artery is occluded at the level of the elbow (arrow). Tapering occlusion is seen in the radial, ulnar, and interosseous arteries. Arteries distal to the wrist are not visualized. C, Angiogram of the left upper extremity 2 years after initial presentation. The brachial artery is recanalized. The distal radial artery, deep palmar arch, and several digital arteries (arrow) are supplied by collateral arteries from the interosseous artery. Journal of Vascular Surgery 2003 38, 175-179DOI: (10.1016/S0741-5214(03)00128-9)

Fig 2 Macroscopic findings. A, Gangrene of the left foot. B, Ulceration of the left index finger. C, Finger ulcer is healed after 4 months of conservative treatment. Journal of Vascular Surgery 2003 38, 175-179DOI: (10.1016/S0741-5214(03)00128-9)

Fig 3 Histologic findings. A, Posterior tibial artery is occluded with chronic thrombus. General architecture and elastic laminae are intact. No atheromatous plaque is observed, and no fibrinoid necrosis is detected in the arterial wall (elastica Masson stain; original magnification, 100×). Inset, Recanalization is seen in the organized thrombus (hematoxylin-eosin stain; original magnification, 400×). B, Immunohistochemical staining for CD8. A slightly increased number of CD8-positive T cells are observed in the intraluminal space (original magnification, 400×). C, Immunohistochemical staining for immunoglobulin G shows deposition along the elastic lamina (original magnification, 400×). Journal of Vascular Surgery 2003 38, 175-179DOI: (10.1016/S0741-5214(03)00128-9)