By M. Brizzio

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Scavenger receptor-mediated endocytosis of oxidized low-density lipoprotein by macrophages has been implicated in the pathogenesis of atherosclerosis. The differentiation of scavenger receptor A negative (SRA-) monocytes in peripheral blood (PB) into SRA positive (SRA+ ) macrophages was believed to take place in atherosclerotic lesions by stimulation of macrophage-colony stimulating factor (M-CSF) 21-24, and it was reported that freshly isolated blood monocytes were negative for SRA 25. We surmised that plaque content - might be exposed to the blood stream after disruption of plaque, and SRA monocytes might differentiate into SRA+ cells in PB by stimulation of M-CSF contained in plaque content, and that increased SRA+ cells in PB might be a useful indication of disrupted, fissured or eroded plaque and coronary thrombus.

Smear preparations were fixed in 95% ethanol solution and stained with the Papanicolaou method. A smear preparation of PB is shown in figure 1. About one million and two hundred thousand nucleated cells were smeared in one slide. Nucleated cells are smeared evenly and precise nuclear structures are excellently preserved. About one thousand nucleated cells were observed in one high power field (×400, Figure 2). Fig. 1. A cytological preparation of peripheral blood stained with the Papanicolaou method.

1. A cytological preparation of peripheral blood stained with the Papanicolaou method. About one million and two hundred thousand nucleated cells are smeared in one slide. Papanicolaou stain. 28 Acute Coronary Syndromes Fig. 2. About one thousand nucleated cells are observed in one high power field (×400). Nucleated cells are smeared evenly and precise nuclear structures are excellently preserved. Papanicolaou stain. 6. Definitions Thrombi were classified into 4 groups according to previously published definitions considering age and constituents of thrombus13, 30 : 1) an eosinophilic mass with neovascularization (organizing thrombus: OT), 2) a structureless eosinophilic (hyalin) mass (fibrin-rich thrombus: FT), 3) Thrombus containing significant quantities of platelets, erythrocytes, fibrin and leukocytes (mixed thrombus: MT), and 4) tightly packed but individually discernible platelets (platelet thrombus: PT).

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