Table 1.
The role of angiogenesis in the classification of arterial lesions compared to tumors: benign verses malignant
| ATHEROMA (Benign) | ADENOMA (Benign) |
| Growth locally | Growth locally |
| Types I and II: (Initial lesion – fatty streak) | Lesion remains less 3–4 mm if no angiogenesis |
| Type III: (Isolated extracellular lipid pools) Preatheroma (Tissue damage and disorder) [Virmani R, Pathological intimal thickening] | |
| Type IV: (Formation of lipid core) Atheroma (Massive structural damage to intima). ANGIOGENESIS INDUCED: [Virmani R, fibrous cap atheroma] | ANGIOGENESIS INDUCED: |
| Malignant Transformation ANGIOGENESIS | Malignant Transformation ANGIOGENESIS |
| Type V: Fibroatheroma (SMC) Proliferation – Migration Fibromuscular tissue layers produced Thickening of intima and media ANGIOGENESIS Development of protective fibrous cap [Virmani R, thick-cap fibrous atheroma] |
Now rapid cell growth Exponential More invasive displacing normal tissue ANGIOGENESIS: ANGIOGENESIS: |
|
Type VI: Surface defect, hematoma, thrombosis [Vermani R, Thin-cap fibrous atheroma: Vulnerable Plaque] ANGIOGENESIS MAGIFIED: Intraplaque hemorrhage: (IPH): Contributing to unstable vulnerable plaque rupture and thrombosis. Cholesterol emboli to: Extremities (PAD), Kidney, Brain. (TIAs), Coronaries |
Bleeding and ulceration Metastasis to Liver, Lung Brain |
| Type VII: Calcification predominates. | ANGIOGENESIS: Recapitulated in distant organs |
| Type VIII: Fibrous tissue changes predominate. Type V to type VIII: Recapitulation of lesions: Repeated layering of eccentric atheroma. |
ANGIOGENESIS: Recapitulated in distant organs DEFINITIONS TO FOLLOW: |
| 1. ATHEROMA: G. athere, gruel or porridge + oma, tumor. | |
| 2. TUMOR: L. a swelling. Syn. neoplasm. | |
| 3. NEOPLASM: G. neos, new. plasma, thing formed.. Syn. New growth. | |
| 4. BENIGN: Fr. Fr.L., benignus, kind. Denoting the mild character of an illness or the non malignant character of a neoplasm. | |
| 5. MALIGNANT: L. maligno p.(ant). To do anything maliciously. Resistant to treatment; occurring in sever form, and frequently fatal; tending to become worse. In reference to neoplasm, having the property of being locally invasive and destructive with growth and metastasis. | |
| 6. ATHEROSCLEROSIS: G. athere, gruel or porridge + skleros, hard. (A malignant form of atheroma implying the presence of a proinflammatory, prothrombotic, profibrotic, pro oxidative – redox stress, and proangiogenic state). | |
| SOURCE: Steadman's Medical Dictionary. 26th Edition. 1995 Williams and Wilkins. Baltimore, MD. USA | |