Page 1 of 1: an example of which of the following?

mdali007 · Credits: 5763 My Scrapbook

bbf Autopsy examination of the main pulmonary arteries of a man presumed to have died from a massive cerebrovascular hemorrhage demonstrates a rubbery, congealed mass of blood that is easily detached from the vessel wall. The clot has a homogeneous color without evidence of layering on low power microscopic examination. This is an example of which of the following?

Options:

A. Canalized thrombus.

B. Mural thrombus.

C. Occlusive embolus.

D. Occlusive thrombus.

E. Postmortem clot.

mdali007 · Credits: 5763 My Scrapbook

The correct answer is E.

At autopsy, it is important to be able to distinguish postmortem clots, such as those observed in this subject, from clinically significant premortem thrombi or emboli. The lines of Zahn are red, cell-rich layers in a thrombus that appear dark, grossly. Alternating with these lines are lighter layers rich in platelets and fibrin. No lines of Zahn are seen in postmortem clots, but are present in clots formed premortem, including mural (wall) thrombi (choice B)>, occlusive thrombi (choice D), or emboli (choice C) (from other vessels). Recent embolus-like postmortem clots may not be attached to the vessel wall, but can be distinguished by the presence of either lines of Zahn or areas of fibrosis (uncommon) within them. With time, thrombi are replaced by fibrous tissue and capillaries will recanalize the thrombus (choice A). In practice, this does not usually restore adequate blood flow, since the cross-sectional area of the capillary bed is usually much lower than the cross-sectional area of the original vessel.

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