Figure 27

Antemortem abdominal CAT scans showing polyarteritis nodosa (A-E). These are the same kidneys shown in Figure 2-6. Demonstrated are echogenic oval defects in both kidneys corresponding to the aneurysms (pseudoaneurysms), and a perirenal hematoma adjacent to the right kidney (left sides of panels) that resulted from rupture of one of the aneurysms.

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FIGURE 2-7 (Continued)

Antemortem abdominal CAT scans showing polyarteritis nodosa.

FIGURE 2-8 (see Color Plate)

Micrograph of transmural fibrinoid necrosis of an arcuate artery in acute polyarteritis nodosa. The fibrinoid necrosis results from lytic destruction of vascular and perivascular tissue with spillage of plasma constituents, including the coagulation proteins, into the zone of destruction. The coagulation system, as well as other mediator systems, is activated and fibrin forms in the zone of necrosis, thus producing the deeply acidophilic (bright red) fibrinoid material. Marked perivascular inflammation is seen, which is the basis for the archaic term for this disease, ie, periarteritis nodosa. Note that the glomerulus is not inflamed. (Hematoxylin and eosin stain, X200.)

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