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Granulomata Cholesterol

Jon Wilson, MD neuropathologist at arkana laboratories
By Jon Wilson, MD

Sep 09, 2022

This 70-year-old patient presented with a transient left sided weakness. Their past medical history included hypertension, hypothyroidism, and coronary artery disease status-post placement of cardiac stents. Laboratory studies showed mild elevation of CPK (500). Brain MRI showed acute lacunar ischemic infarcts involving the left pons.


What do the cleft-like optically clear spaces within the foci of granulomata represent?

A. Cholesterol

B. Foreign body

C. Talc

D. Artifact



Answer: Cholesterol


The optically clear spaces are characteristic of cholesterol crystals. Lipids (including cholesterol) are extracted during tissue processing for paraffin block embedding. The biconcave optically clear spaces correspond to the areas that were occupied by cholesterol from cellular breakdown and/or atheroemboli.


Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.