Buerger's disease other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]


Overview

Biopsy is not routinely performed, however, may be carried out in patients older than 45 years presenting with nodules subcutaneously or migratory thrombophlebitis, with uncharacteristic large artery involvement and/or the presence of higher than normal anticardiolipin antibodies. Biopsy may therefore be helpful in the diagnosis of Buerger's disease. Biopsy findings suggestive of Buerger's disease include small and medium vessel involvement, hypercellularity with leukocytic infiltration, segmental affection, occlusion with inflammatory thrombi (may or may not be organized depending on the stage of disease), sparing of the internal elastic laminae, formation of microabscesses, and multinucleated giant cells.

Other Imaging Findings

Biopsy is not routinely performed, however, may be carried out in the following conditions:[1][2][3]

  • Biopsy findings suggestive of Buerger's disease include:
    • Small and medium vessel involvement
    • Hypercellularity with leukocytic infiltration
    • Segmental affection
    • Normal areas between diseased areas
    • Occlusion with inflammatory thrombi
    • May or may not be organized depending on the stage of disease
    • Sparing of the internal elastic laminae
    • Formation of microabscesses
    • Presence of multinucleated giant cells
Source:https://medical-dictionary.thefreedictionary.com, demonstrates complete occlusion of a veseel by an inflammatory thrombus. Arrows indicate the presence of microabscesses. [4]

References

  1. Graziani L, Morelli L, Parini F, Franceschini L, Spano P, Calza S, Sigala S (April 2012). "Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases". Ann Vasc Surg. 26 (3): 387–95. doi:10.1016/j.avsg.2011.08.014. PMID 22285343.
  2. Lambeth JT, Yong NK (July 1970). "Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement". Am J Roentgenol Radium Ther Nucl Med. 109 (3): 553–62. PMID 5431503.
  3. Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE (December 2012). "Imaging appearances of Buerger's disease complications in the upper and lower limbs". Clin Radiol. 67 (12): 1207–11. doi:10.1016/j.crad.2012.04.005. PMID 22784658.
  4. https://medical-dictionary.thefreedictionary.com/_/viewer.aspx?path=MosbyMD&name=thromboangiitis-obliterans.jpg&url=https%3A%2F%2Fmedical-dictionary.thefreedictionary.com%2Fthromboangiitis%2Bobliterans

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