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The ultrastructural changes of cutaneous and subcutaneous capillaries and venules in 6 cases of severe, chronic venous insufficiency were examined. The findings in all cases consisted of numerous and characteristic alterations of the vessel wall structure and of the pericapillary space which are supposed to be due to the increased intravenous pressure. The intercellular spaces are enlarged to wide channels through which erythrocytes pass into the perivascular spaces. Microvesicles occur in great numbers, they are arranged in chain-like formations and seem to come together to form transendothelial channels. Around the capillaries, edematous fluid with proteins and erythrocytes accumulates. Phagocytosis of erythrocytes, siderosomes and collagen fibrils by macrophages is observed. Within the endothelial cells there is an abundance of Weibel-Palade bodies and of multivesicular bodies. The former are frequently seen in contact with the luminal cell membrane. Weibel-Palade bodies are believed to be involved in the clotting mechanism.

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The case history of a 23-year-old man presenting with a progressive tender swelling in both temporal regions is described. Eosinophilia varied between 28% and 48% and IgE was markedly increased (1,380 U/l). Arteriography revealed tortuous, enlarged temporal and occipital arteries intersected by stenoses. The pathology diagnosis was chronic necrotizing panarteritis of the temporal artery with pseudoaneurysms, fibrinoid necroses, scar tissue, occasional giant cells, and abundant hypereosinophilia.