Cross section of an aeriole shows ‘onion skin thickening’ of its wall. It is seen in:
**Core Concept**
The onion skin thickening refers to the concentric laminations of collagen and mucopolysaccharides within the arterial wall, characteristic of a specific vascular pathology. This histopathological feature is indicative of a condition that involves chronic inflammation and vascular remodeling.
**Why the Correct Answer is Right**
Onion skin thickening is typically seen in systemic vasculitis, particularly in conditions like polyarteritis nodosa (PAN). The inflammation and subsequent scarring of the arterial wall lead to the characteristic layered appearance. The immune complex deposition and subsequent activation of the complement system contribute to the inflammation, which results in the thickening of the arterial wall.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because onion skin thickening is not characteristic of atherosclerosis, which involves lipid deposition and fibrosis within the arterial wall, resulting in a more diffuse thickening rather than laminated layers.
**Option B:** This option is incorrect because diabetic angiopathy involves microvascular damage and does not typically result in onion skin thickening of the arterial wall.
**Option C:** This option is incorrect because hypertensive arteriolosclerosis involves hyaline thickening of the arterial wall, which is different from the laminated layers seen in onion skin thickening.
**Clinical Pearl / High-Yield Fact**
Onion skin thickening is a hallmark of systemic vasculitis, particularly polyarteritis nodosa (PAN), and should be considered in the differential diagnosis of patients with chronic hypertension, renal failure, or gastrointestinal bleeding.
**Correct Answer:** C.