A muscular artery shows marked myointimal thickening that almost obliterates the lumen. This vessel has been stained with the elastic-van Gieson stain to show the inner and outer, black, elastic layers of the media, which shows no hypertrophy. The intimal thickening may indicate old thrombosis or, alternatively, a proliferation that is stimulated by cytokines activated by RBC-endothelial interactions in sickle cell disease. This was the only such vessel found in the sections from this patient.
Similar lesions are very frequent in patients with chronic sickle cell lung disease.