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==Overview==
==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. Findings on an biopsy 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 stage of disease), sparing of the internal elastic laminae, formation of microabscesses, and multinucleated giant cells.  
[[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 [[Anti-cardiolipin antibodies|anticardiolipin antibodies]]. [[Biopsy]] may therefore be helpful in the diagnosis of Buerger's disease. Findings on an biopsy suggestive of Buerger's disease include small and medium vessel involvement, hypercellularity with leukocytic infiltration, segmental affection, occlusion with inflammatory [[Thrombus|thrombi]] (may or may not be organized depending on stage of disease), sparing of the internal elastic laminae, formation of microabscesses, and [[multinucleated giant cells]].  


==Other Imaging Findings==
==Other Imaging Findings==
Biopsy is not routinely performed, however, may be carried out in patients that meet the following criteria:<ref name="pmid22285343">{{cite journal |vauthors=Graziani L, Morelli L, Parini F, Franceschini L, Spano P, Calza S, Sigala S |title=Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases |journal=Ann Vasc Surg |volume=26 |issue=3 |pages=387–95 |date=April 2012 |pmid=22285343 |doi=10.1016/j.avsg.2011.08.014 |url=}}</ref><ref name="pmid5431503">{{cite journal |vauthors=Lambeth JT, Yong NK |title=Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement |journal=Am J Roentgenol Radium Ther Nucl Med |volume=109 |issue=3 |pages=553–62 |date=July 1970 |pmid=5431503 |doi= |url=}}</ref><ref name="pmid22784658">{{cite journal |vauthors=Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE |title=Imaging appearances of Buerger's disease complications in the upper and lower limbs |journal=Clin Radiol |volume=67 |issue=12 |pages=1207–11 |date=December 2012 |pmid=22784658 |doi=10.1016/j.crad.2012.04.005 |url=}}</ref>
Biopsy is not routinely performed, however, may be carried out in patients that meet the following criteria:<ref name="pmid22285343">{{cite journal |vauthors=Graziani L, Morelli L, Parini F, Franceschini L, Spano P, Calza S, Sigala S |title=Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases |journal=Ann Vasc Surg |volume=26 |issue=3 |pages=387–95 |date=April 2012 |pmid=22285343 |doi=10.1016/j.avsg.2011.08.014 |url=}}</ref><ref name="pmid5431503">{{cite journal |vauthors=Lambeth JT, Yong NK |title=Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement |journal=Am J Roentgenol Radium Ther Nucl Med |volume=109 |issue=3 |pages=553–62 |date=July 1970 |pmid=5431503 |doi= |url=}}</ref><ref name="pmid22784658">{{cite journal |vauthors=Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE |title=Imaging appearances of Buerger's disease complications in the upper and lower limbs |journal=Clin Radiol |volume=67 |issue=12 |pages=1207–11 |date=December 2012 |pmid=22784658 |doi=10.1016/j.crad.2012.04.005 |url=}}</ref>
**Older than 45 years of age
**Older than 45 years of age
**Nodules subcutaneously or migratory thrombophlebitis
**Nodules subcutaneously or [[migratory thrombophlebitis]]
**Uncharacteristic large artery involvement
**Uncharacteristic large artery involvement
**Presence of higher than normal anticardiolipin antibodies
**Presence of higher than normal [[Anti-cardiolipin antibodies|anticardiolipin antibodies]]
*Findings on an biopsy suggestive of Buerger's disease include:
*Findings on an [[biopsy]] suggestive of Buerger's disease include:
**Small and medium vessel involvement  
**Small and medium vessel involvement  
**Hypercellularity with leukocytic infiltration
**Hypercellularity with leukocytic infiltration
**Segmental affection  
**Segmental affection  
***Normal areas between diseased areas
***Normal areas between diseased areas
**Occlusion with inflammatory thrombi
**Occlusion with inflammatory [[Thrombus|thrombi]]
**May or may not be organized depending on stage of disease
**May or may not be organized depending on stage of disease
**Sparing of the internal elastic laminae
**Sparing of the internal elastic laminae
**Formation of microabscesses
**Formation of microabscesses
**Presence of multinucleated giant cells  
**Presence of [[multinucleated giant cells]]


[[Image:Thromboangiitis-obliterans.jpg|thumb|center|1000px|Source:https://medical-dictionary.thefreedictionary.com, demonstrates complete occlusion of a veseel by an inflammatory thrombus. Arrows indicate the presence of microabscesses. <ref>https://medical-dictionary.thefreedictionary.com/_/viewer.aspx?path=MosbyMD&name=thromboangiitis-obliterans.jpg&url=https%3A%2F%2Fmedical-dictionary.thefreedictionary.com%2Fthromboangiitis%2Bobliterans</ref>]]
[[Image:Thromboangiitis-obliterans.jpg|thumb|center|1000px|Source:https://medical-dictionary.thefreedictionary.com, demonstrates complete occlusion of a veseel by an inflammatory thrombus. Arrows indicate the presence of microabscesses. <ref>https://medical-dictionary.thefreedictionary.com/_/viewer.aspx?path=MosbyMD&name=thromboangiitis-obliterans.jpg&url=https%3A%2F%2Fmedical-dictionary.thefreedictionary.com%2Fthromboangiitis%2Bobliterans</ref>]]

Revision as of 14:54, 12 April 2018

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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. Findings on an biopsy 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 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 patients that meet the following criteria:[1][2][3]

  • Findings on an biopsy 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 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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