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The aim of this study was to determine the ultrastructural characteristics of   cell populations and extracellular matrix components in the wall of ruptured   atherosclerotic abdominal aortic aneurysm (AAA). We analyzed 20 samples of   ruptured AAA. For orientation to the light microscopy, we used routine   histochemical techniques by standard procedures. For ultrastructural   analysis, we applied transmission electron microscopy (TEM). Our results have   shown that ruptured AAA is characterized by the remains of an advanced   atherosclerotic lesion in the intima followed by a complete absence of   endothelial cells, the disruption of basal membrane and disruption of   internal elastic lamina. On plaque margins as well as in the inner media we   observed smooth muscle cells (SMCs) that posses a euchromatic nucleus, a   well-developed granulated endoplasmic reticulum around the nucleus and   reduced myofilaments. The remains of the ruptured lipid core were acellular   in all samples; however, on the lateral sides of ruptured plaque we observed   a presence of two types of foam cells (FCs), spindle- and star-shaped.   Fusiform FCs possess a well-differentiated basal lamina, caveolae and   electron dense bodies, followed by a small number of lipid droplets in the   cytoplasm. Star-shaped FCs contain a large number of lipid droplets and do   not possess basal lamina. On the inner margins of the plaque, we observed a   large number of cells undergoing apoptosis and necrosis, extracellular lipid   droplets as well as a large number of lymphocytes. The media was thinned out   with disorganized elastic lamellas, while the adventitia exhibited leukocyte   infiltration. The presented results suggest that atherosclerotic plaque in   ruptured AAA contains vascular SMC synthetic phenotype and two different   types of FCs: some were derived from monocyte/macrophage lineage, while   others were derived from SMCs of synthetic phenotype. The striking plaque   hypocellularity was the result of apoptosis and necrosis of different cell   populations. [Projekat Ministarstva nauke Republike Srbije, br. III41007 i   br. 41002

Ultrastructural characteristics of the vascular wall components of ruptured atherosclerotic abdominal aortic aneurysm