Atheromatous

Atheromatous is an adjective used in pathology to describe tissues or lesions associated with atheroma formation in arteries, i.e., the plaques that characterize atherosclerosis. An atheromatous plaque typically contains a lipid-rich necrotic core, a fibrous cap, inflammatory cells, and may show calcification. The term derives from atheroma, from Greek athēr "porridge" and -oma "tumor."

Pathogenesis and features: Most plaques originate in the intima of arterial walls due to risk factors such as high low-density lipoprotein, hypertension, diabetes, and smoking. Lipids accumulate, become oxidized, triggering an inflammatory response. Macrophages take up lipids and become foam cells; smooth muscle cells migrate, proliferate, and synthesize extracellular matrix, forming a fibrous cap. Plaques may remain relatively stable or become vulnerable to rupture, leading to thrombosis.

Clinical significance: Atheromatous changes can narrow vessels (stenosis), impair blood flow, or rupture with thrombosis, leading to myocardial infarction, stroke, or peripheral arterial disease. Calcification can occur within plaques and may be detected on imaging, contributing to vessel stiffness and altered hemodynamics.

Diagnosis and management: Detection is typically via imaging modalities such as ultrasound, computed tomography, or magnetic resonance imaging, which reveal plaque burden and vessel narrowing. Management focuses on risk-factor modification and, where indicated, lipid-lowering therapy, antiplatelet agents, and revascularization for significant stenosis. The term atheromatous emphasizes the lipid-rich, inflammatory nature of these vascular lesions within the spectrum of atherosclerotic disease.