An autopsy of a 14-year-old boy who died in a motor vehicle crash (MVC) shows several minimally raised yellow spots on the inner surface of the abdominal aorta. The rest of the cardiovascular findings and autopsy are unremarkable. He had no known medical problems, and there is no family history of cardiovascular disease (CVD) or sudden cardiac death (SCD).

What is the most likely predominant cell type in these lesions on microscopy?

The minimally raised yellow spots found in the autopsy are likely the initial stages of atherosclerosis, with the predominant cell type being foam cells. These cells are formed from white blood cells that have absorbed harmful low-density lipoprotein particles, marking the start of this cardiovascular disease.

Explanation:

The minimally raised yellow spots that were found on the internal surface of the deceased boy's abdominal aorta during the autopsy are most likely associated with a very early stage of atherosclerosis, which is a cardiovascular disease. These spots, often found in atherosclerosis, are known as fatty streaks. They are formed due to the accumulation of lipids and other substances within the walls of the arteries and represent the earliest visible lesions in this disease.

The most predominant cell type in these lesions is the foam cell. These are large cells with a foamy appearance due to the presence of numerous lipid-filled vesicles within their cytoplasm. Foam cells are actually derived from macrophages, a type of white blood cell, that have ingested oxidized low-density lipoprotein (LDL) particles. The accumulation of these foam cells initiates the formation of fatty streaks in the arterial wall and thus begins the progression of atherosclerosis.

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