Figure 2. Representative Lesion Morphologies for Progressive Human Coronary Atherosclerosis.
(A) The earliest atherosclerotic lesion, pathological intimal thickening, highlighted by lipid pools (LP) in the deep intima (Movat pentachrome stain) with CD68+ macrophages near the luminal surface. (B) Fibroatheroma with early necrosis, showing the conversion of a lipid pool into a necrotic core; note the invasion of the lipid pool by macrophages. (C) A late core fibroatheroma, distinguished by its lytic environment and increase in size. (D) An advanced thin-cap fibroatheroma (rupture-prone lesion), characterized by a relatively large necrotic core and thin fibrous cap infiltrated by macrophages. NC = necrotic core. Adapted, with permission, from Virmani R, Burke AP, Farb A, Gold HK, Finn AV, Kolodgie FD. Plaque rupture. In: Virmani R, Narula J, Leon M, Willerson J, editors. The Vulnerable Atherosclerotic Plaque: Strategies for Diagnosis and Management. Malden, MA: Blackwell Futura, 2007:37–59.