Cholesterol emboli

Microphotograph showing cholesterol emboli in an interlobular artery. Note the sharp-edged, needle-shaped cholesterol clefts. Cholesterol dissolves during routine processing.
The presence of needle-shaped, sharp-edged cholesterol clefts in the lumens of arteries and arterioles or in glomeruli is diagnostic. The cholesterol dissolves during routine processing, but if unstained frozen sections are examined under polarized light, the birefringent cholesterol crystals are clearly visible. Cholesterol crystals occluding vascular lumina are frequently surrounded by macrophages, which may form giant cells.Eosinophils may also be seen around the cholesterol clefts.
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