Cytohistology and immunocytochemistry characteristics of neointimal thickening in aortic coarctation of adult tipe

Abstract

The aim of this study was to examine phenotype status of smooth muscle cells in adult coarctation, their proliferation activity and presence of inflammation in this lesion. We used bioptic material taken from 8 children, in age of 3-10. The tissues were fixed in formalin and embedded in paraffin. Sections 5 micrometers thick were stained by DAKO LSAB+/HRP technique to identify alpha-smooth muscle actin-alpha-SMA, vimentin, desmin, myosin haevy chains-MHC, CD3, CD45, S-100 and Proliferating Cell Nuclear Antigen-PCNA. Our results show significant hypocellularity in subendothelium, especially at posterior wall of aorta, but we conclude that it wasn't due to inflammation, because there wasn't CD3 or CD45 immunoreactivity. These results don't match with literature data, which demonstrate cystic medial necrosis of the base of aortic coarctacion. On the other side, there is thickening in subendothelium with dense elastic fibers. Characteristics of media under this lesion are fragmentation, fenestration and reduplicated elastic lamelae, cysts with mukopolisaharids and dedifferentiation of smooth muscle cells, which summary shows destruction of media began in previous stage of neonatal coarctation.