Hyperplastic arteriolosclerosis
Summary
Concentric 'onion-skin' thickening of arteriolar walls due to smooth muscle hyperplasia, classically seen in malignant (severe) hypertension. May progress to fibrinoid necrosis.
Detail
Hyperplastic arteriolosclerosis is characterized by concentric, laminated 'onion-skin' thickening of arterioles caused by reduplicated basement membranes and smooth muscle hyperplasia, narrowing the lumen. It is the hallmark vascular lesion of malignant hypertension (diastolic >120 mmHg), often accompanied by fibrinoid necrosis and acute renal failure. Clinically associated with encephalopathy, papilledema, and acute renal injury (malignant nephrosclerosis). Contrast with hyaline arteriolosclerosis: homogeneous pink protein deposition seen in benign hypertension and diabetes mellitus. Classic boards image: kidney biopsy showing onion-skin arterioles + fibrinoid necrosis in a young patient with severe BP.
Sources
- Robbins Basic Pathology 10th ed
- Pathoma
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.