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CARDIOvASCuLAR ``CARdIOvASCulAR—PATHOlOGY CARDIOvASCuLAR ``CARdIOvASCulAR—PATHOlOGY SECTION III 301

Hyperlipidemia signs
Xanthomas Plaques or nodules composed of lipid-laden histiocytes in skin A , especially the eyelids
(xanthelasma B ).

Tendinous xanthoma Lipid deposit in tendon C , especially Achilles.
Corneal arcus Lipid deposit in cornea. Common in elderly (arcus senilis D), but appears earlier in life with
hypercholesterolemia.
A B C D

Arteriosclerosis Hardening of arteries, with arterial wall thickening and loss of elasticity.
Arteriolosclerosis Common. Affects small arteries and arterioles. Two types: hyaline (thickening of vessel walls 2°
to plasma protein leak into endothelium in essential hypertension or diabetes mellitus A ) and
hyperplastic (“onion skinning” in severe hypertension B with proliferation of smooth muscle
cells).
Mönckeberg sclerosis Uncommon. Affects Medium-sized arteries. Calcification of internal elastic lamina and media of
(Medial calcific arteries Ž vascular stiffening without obstruction. “Pipestem” appearance on x-ray C . Does not
sclerosis) obstruct blood flow; intima not involved.
A B C

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