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Figure 2 Photomicrographs obtained at autopsy of the coronary arterial site responsible for variant angina in patient No. 10. Histological examination of the affected segment of the right coronary artery shows a focal obstructive fibrous plaque with a superimposed thrombus. There are two distinct intimal layers in the plaque. The inner, light-colored layer, is a myxedematous area of the neointima with an abundance of stellate smooth muscle cells and a considerable amount of extracellular matrix. The outer layer, dark-colored layer, consists of so-called "old" plaque that is mainly composed of relatively hypocellular dense fibrous connective tissue (upper). Neointimal hyperplasia with inflammatory cell infiltration is observed in the inner layer, and resembles the histological features in the atherectomy specimens obtained from 14 other patients with variant angina in the present study. Intimal hemorrhage (arrow) is also observed (lower). (Upper; elastica von Gieson stain, x4. Lower; hematoxylin and eosin stain, x60.)
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