ATHEROSKLEROSIS

Morfologi
Fatty dots
lesi sub endotel 1 mm
Lunak
Kekuningan

Fatty streaks
elevasi 3 mm s/d 1,5 cm axis vessel

 Histologi
foam cells
SMCs
few T-limfosit
ekstraseluler lipid debris

 Atheromatous plaque

fibrous cap
bentuk ireguler
putih keabuan
Lokasi :

lower aorta abdominal

a. coronary
a. poplitea
descending aorta thoracalis
internal carotid arteri
circle of Willis

 Complicated plaque

Calcification
Fissuring or ulceration
Cholesterol emboli / thrombosis
Hemorrhage
Aneurysma aorta

Fatty streaks

Figure 11-6 Fatty streak-a collection of foam cells in the intima. A, Aorta with
fatty streaks (arrows), associated largely with the ostia of branch vessels.

Figure 11-7 Schematic depiction of the major components of welldeveloped intimal atheromatous plaque overlying an intact media.
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

Figure 11-9
Histologic features
of atheromatous
plaque in the
coronary artery. A,
Overall architecture
demonstrating
fibrous cap (F) and a
central necrotic
(largely lipid) core
(C). The lumen (L)
has been
moderately
narrowed. Note that
a segment of the
wall is plaque free
(arrow). In this
section, collagen has
been stained blue
(Masson's trichrome
stain).
2005
Elsevier
Downloaded from: Robbins & Cotran Pathologic Basis of Disease
(on 20
June 2006 08:17 AM)

Figure 11-9 Histologic

features of atheromatous
plaque in the coronary
artery. B, Higher-power
photograph of a section
of the plaque shown in A,
stained for elastin
(black), demonstrating
that the internal and
external elastic
membranes are
destroyed and the media
of the artery is thinned
under the most
advanced plaque (arrow).
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

Figure 11-9 Histologic

features of atheromatous
plaque in the coronary artery.
C, Higher-magnification
photomicrograph at the
junction of the fibrous cap
and core, showing scattered
inflammatory cells,
calcification (broad arrow),
and neovascularization (small
arrows).

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE & COMPLICATED LESIONS

Fibrosis
kristal
Kolester
in

Bercak kuning melebar/

luas/membesar

3. COMPLICATED LESIONS

Fibrosis luas di intima

Kalsifikasi pembuluh darah
Bercak meluas menonjol
ulkus

HEMANGIOMA
Neoplasma jinak pembuluh darah /
limfe
Histopatologi :
1. Hemangioma cavernosa
2. Hemangioma capillaris

Hemangioma cavernosa
Lokasi :
Kulit
Mukosa
visera :

Hati
lien
Pancreas
cerebellum (von Hippel-Lindau) + lesi red-blue, spongious
2-3 cm

batas jelas
tidak berkapsul

Hemangioma capillaris
Lokasi :
Kulit
Subkutan
mukosa mulut/bibir

Beberapa mm cm
merah sampai biru
Mudah berdarah
Trauma
ulserasi

Figure 11-30 Hemangiomas. A, Hemangioma of the tongue. B, Histology of

juvenile capillary hemangioma. C, Histology of cavernous hemangioma. D,
Pyogenic granuloma of the lip. (A and D, courtesy of John Sexton, M.D.,
Beth Israel Hospital, Boston; B, courtesy of Christopher D.M. Fletcher, M.D.,
Brigham and Women's Hospital, Boston; and C, courtesy of Thomas
Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

Figure 11-30 Hemangiomas. B, Histology of juvenile capillary

hemangioma. (courtesy of Christopher D.M. Fletcher, M.D.,
Brigham and Women's Hospital, Boston)

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

Figure 11-30 Hemangiomas.C, Histology of cavernous

hemangioma. C, courtesy of Thomas Rogers, M.D.,
University of Texas Southwestern Medical School, Dallas,

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)
2005 Elsevier

MIOKARD INFARK
Ischemis Heart Disease
Nekrosis iskemi akut miokard
2 macam :
transmural
sub endokard

 Transmural
> 2,5 cm
seluruh lapisan miokard

Sub endokard
1/2 s/d 1/3 lapisan miokard

MORFOLOGI
Dimulai dari nekrosis koagulasi
dan keradangan
Diikuti pembentukan jaringan
granulasi, resorbsi nekrosis
miokardium
Diakhiri dengan organisasi
granulasi sampai fibrosis

0 2 jam
(-)
4 8 jam
18 24 jam
hiperemi
24 72 jam
10 hari
Mgg 7 8

: perubahan macros
: pucat
: pucat, kadang
: hiperemi, perlunakan
: sangat kuning
: fibrosis

URUTAN PERISTIWA INFARK

JANTUNG
WAKTU

MAKROSKOPI
S

MIKROSKOPIS

PERUBAHA
N

15 DETIK

EKG

OEDEMA

ELEKTRON
MIKROSKOPE
(+)

HIALINISASI
SERABUT
(EOSINOFLIK
HOMOGEN)

Ca ++ HILANG

3 JAM

PENGELOMPOKAN
SARCOPLASMA
DEBLEMAU

Na+
ENZYM ASAM
SITRAT

4 JAM

REAKSI TTC (-)

NEKROSIS

30 60 MENIT

2 JAM

CPK

SERUM

URUTAN PERISTIWA INFARK

JANTUNG
WAKTU

MAKROSKOPIS

MIKROSKOPIS

6 JAM

PUCAT*

REAKSI LEUKOSIT

9 JAM

KUNING KENYAL

NEKROSIS MELUAS

18 24 JAM

KUNING KENYAL

NEKROSIS LENGKAP

2 3 MINGGU

JARINGAN
GRANULASI

JARINGAN
GRANULASI

5 MINGGU

JARINGAN PARUT

JARINGAN PARUT

2 BULAN

PUTIH KENYAL
FIBROSIS

JARINGAN PARUT

PERUBAHAN
CPK

SERUM

ENZYM
SERUM