Lines of Zahn
{{Short description|Tissue damage caused by thrombosis}}
{{Infobox medical condition (new)
| name = Lines of Zahn
| image = Pulmonary thromboembolus, recent (3626658803).jpg
| caption = A recent pulmonary thrombo-embolus with prominent lines of Zahn. The pale areas consist of fibrin and platelets. The red areas consist of erythrocytes.
| specialty = Pathology
| causes = Thrombosis
}}
Lines of Zahn are a characteristic of thrombi. They have layers, with lighter layers of platelets and fibrin, and darker layers of red blood cells. They are more present on thrombi formed with faster blood flow, more so on thrombi from the heart and aorta. They are only seen on thrombi formed before death. They are named after German–Swiss pathologist Friedrich Wilhelm Zahn.
Definition
Lines of Zahn are a characteristic of thrombi.{{Cite book|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780120777501500155|title=Thrombosis and Bleeding Disorders - Theory and Methods|publisher=Academic Press|year=1971|isbn=978-0-12-077750-1|pages=488–534|language=en|chapter=11 - Thrombosis|doi=10.1016/B978-0-12-077750-1.50015-5}} They have visible and microscopic alternating layers (laminations).{{cite journal | vauthors = Lee R, Adlam D, Clelland CA, Channon KM | title = Lines of Zahn in coronary artery thrombus | journal = European Heart Journal | volume = 33 | issue = 9 | pages = 1039 | date = May 2012 | pmid = 22345124 | doi = 10.1093/eurheartj/ehs028 | doi-access = free }}{{cite journal | vauthors = Saha P, Humphries J, Modarai B, Mattock K, Waltham M, Evans CE, Ahmad A, Patel AS, Premaratne S, Lyons OT, Smith A | display-authors = 6 | title = Leukocytes and the natural history of deep vein thrombosis: current concepts and future directions | journal = Arteriosclerosis, Thrombosis, and Vascular Biology | volume = 31 | issue = 3 | pages = 506–512 | date = March 2011 | pmid = 21325673 | pmc = 3079895 | doi = 10.1161/ATVBAHA.110.213405 }} Platelets mixed with fibrin form lighter layers. Red blood cells form darker layers. Sometimes, the term "lines of Zahn" only refers to the lighter layers.{{cite journal | vauthors = Stone J, Hangge P, Albadawi H, Wallace A, Shamoun F, Knuttien MG, Naidu S, Oklu R | display-authors = 6 | title = Deep vein thrombosis: pathogenesis, diagnosis, and medical management | journal = Cardiovascular Diagnosis and Therapy | volume = 7 | issue = Suppl 3 | pages = S276–S284 | date = December 2017 | pmid = 29399531 | pmc = 5778510 | doi = 10.21037/cdt.2017.09.01 | doi-access = free }}
Evaluation
Lines of Zahn can be used to confirm diagnosis of a thrombus. Their presence implies thrombosis at a site of rapid blood flow that happened before death. They are more common in thrombi formed in the heart or aorta.{{cite journal | vauthors = Heo JH, Nam HS, Kim YD, Choi JK, Kim BM, Kim DJ, Kwon I | title = Pathophysiologic and Therapeutic Perspectives Based on Thrombus Histology in Stroke | journal = Journal of Stroke | volume = 22 | issue = 1 | pages = 64–75 | date = January 2020 | pmid = 32027792 | pmc = 7005358 | doi = 10.5853/jos.2019.03440 }} In veins or smaller arteries, where flow is not as constant, they occur less frequently. They are also only seen on thrombi formed when blood is flowing. This is a distinguishing marker between thrombi that formed before death and after death.{{cn|date=February 2021}}
History
Lines of Zahn are named after German–Swiss pathologist Friedrich Wilhelm Zahn.{{citation|title=Stedman's Medical Dictionary|year=2006| veditors = Stegman JK |edition=28th |location=Baltimore, MD|publisher=Lippincott, Williams, & Wilkins}}
Additional images
File:Histopathology showing lines of Zahn in a thrombus.jpg|Thrombus showing circumferential lines of Zahn.
File:Laminations in a thrombus - low mag.jpg|Low magnification micrograph showing laminations in a thrombus in a fatal pulmonary embolism. H&E stain.
File:Laminations in a thrombus - intermed mag.jpg|Intermediate magnification micrograph showing laminations in a thrombus in a fatal pulmonary embolism. H&E stain.
File:Laminations in a thrombus - high mag.jpg|High magnification micrograph showing laminations in a thrombus in a fatal pulmonary embolism. H&E stain.
References
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Further reading
{{refbegin}}
- {{cite book | vauthors = Kumar V, Abbas AK, Fausto N |title=Robbins & Cotran Pathologic Basis of Disease |date=2005 | edition = 7th | location = Pennsylvania |publisher=Elsevier/Saunders |isbn=978-0-7216-0187-8}}
- {{cite book|title=Underwood's pathology : a clinical approach|publisher=Churchill Livingstone|location=Edinburgh|isbn=978-0-7020-4672-8 |url= http://cune3.tripod.com/pathology/underwood/under06.pdf| edition=6th | veditors = Cross SS |chapter=Chapter 6: Thrombosis, Embolism and Infarction|year=2013}}
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{{Cardiovascular system symptoms and signs}}