“Coral Reef”-Like Calcifications: Communities of Uncomplicated Calcified Nodules

Abstract

The official journal of the Japan Atherosclerosis Society and the Asian Pacific Society of Atherosclerosis and Vascular Diseases Letter to Editor transmural infarction of the small intestine. The most striking autopsy finding was a "coral-reef "-like structure in the aorta, occupying nearly half of the aortic surface, which consisted of groups of calcified grains, typically millet-to pea-sized konpeito 1-like spheroid nodules covered by tiny bulges (Fig. 1). Some nodules were isolated, and others were fused with each other. They were grey-white and slightly shiny. The surface was seemingly smooth, and there was no superficial thrombosis. The wall of the background aorta was hard because of dense calcifications. Histological examinations revealed "coral reef "like calcifications, consisting of protruding clusters of calcified nodules that bulged irregularly and had a convex luminal surface through a disrupted intima with a fractured calcific plate (Fig. 2a-f). The surface was covered by a thin or extremely thin cap lined with endothelium-like cells, generally accompanied by Acute coronary syndromes (ACS) are caused by thrombotic plaque disruption, including plaque rupture (65-70%), plaque erosion (25-30%), and calcified nodules (2-5%) 1). Although calcified nodules are the least frequent cause of ACS, they occur in the heavily calcified and tortuous arteries of older individuals 2). Despite this, it is unclear whether calcified nodules are a culprit of arterial thrombosis or whether they are just a bystander, which is not associated with overlying thrombosis. Here we present a unique case of "coral reef "-like aortic calcifications, characterized by communities of uncomplicated calcified nodules. A 71-year-old Japanese woman who had undergone graft replacement for aortic arch aneurysm and right femoral artery stenting was admitted to our hospital. She was on medication for hypertension. Plasma levels of LDL cholesterol, glucose, and creatinine were 90, 99, and 0.8 mg/dl, respectively. She died of acute Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.