Commonest histological finding in benign hypertension is
(C) (Hyaline arteriosclerosis) (495, 96- Robbins 8th) (678- Harshmohan 7th)* Hyaline arteriosclerosis consists of homogenous pink hyaline thickening of the wall of the arterioles with loss of underlying structural detail.* Encountered frequently in elderly patients whether normotensive, or hypertensive hyaline arterioscleroses is more generalized and more severe in patents with hypertensionQ* It is also common in diabetesQ as a part of the characteristic microangiopathy.Pathogenesis* The lesion reflects leakage of plasma components across vascular endothelium and excessive extra cellular matrix production by smooth muscle cells secondary to the chronic hemodynamic stress of hypertension or a metabolic stress in diabetes that accentuates endothelial cell injury.Also knowHyperplastic arteriosclerosis* It is characteristic of malignant hypertensionQ.* There is concentric laminated thickening of arteriolar wall - onion thickening0.* There is mucinous intimal thickening and fibrous intimal thickening.* There may be accompanied fibrinoid deposite with necrosis of the vessel wall - fibrinoid necrosisThe characteristic histological finding in Benign Hypertension is Hyaline arteriosclerosisBenign NephrosclerosisMalignant NephrosclerosisThis term is used do describe the charges in kidney associated with benign phase of hypertensionThis term is used to describe the changes in kidney associated with malignant or accelerated hypertensionGrossGross* Kidney size is normal 0 or may be moderately reduced 0* Kidnev size is variable0 mav be smaller in size0 (when superimposed on benign nephrosclerosis) or Larger in size (enlarged)0 than normal (patents who develop malignant hypertension in pure form* Grain leather appearance0. The cortical surface has a fine even granularity* Flen bitten appearance0The cortical surface may show multiple small peticheal haemorrhages0 from rupture of arterioles or glomerular capillariesMicroscopic (vascular changes & parenchymal (changes)Microscopic (cascular changes & parenchymal changes)* Hvaline Arteriosclerosis0 Narrowing of the lumens of arterioles and small arteries caused by thickening and hyalinization of the walls* Fibrinoid necrosis of arterioles (Necrotizing arteriolitis0)The vessel wall showa fibrinoid necrosis.Represents an acute event and necrosis is usually not accompanied by intense inflammation* Fibroelastic Hyperplasia, In the intima (intimal thickenningQ). duplication of elastic lamina and hypertrophy of the 'media'* Hyperplastic intimal sclerosis /onion - Skinning Concentric laminae of proliferated smooth muscle cells collagen and basement membrane (producing intimal thickening)* Parenchymal chances (due to ischaemic) Variable degree of Atrophy of parenchyma & due to ischaemia* Parenchymal chances (due to ischaemia)Variable degree of atrophy of parenchyma due to ischaemia infarction necrosis distalQ abnormal vessels may be seen* Fibroid necrosis may be seen in- Polyarteritis nodosa (PAN)- Aschoff's nodule- Malignant hypertension
Proliferative endarteritis
Necrotizing arteriolitis
Hyaline arteriosclerosis
Cystic medial necrosis
Blood Vessels