Diagnose This (January 4, 2021)

What is your diagnosis and what are some possible precipitating events that may lead to this finding?

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Answer: The light microscopic image depicts an artery with a cholesterol embolus. Approximately three-quarters of cases demonstrating atheromatous emboli are iatrogenic in nature and due to invasive, specifically vascular, procedures such as coronary artery bypass, aortic repair (i.e. aneurysm), and cardiopulmonary resuscitation. Other known causes include anticoagulant therapy as well as secondary to trauma while the remainder are spontaneous in nature. Risk factors for this finding include hypertension, diabetes, smoking and hyperlipidemia.