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Ependymomas—an immunohistochemical study of 14 cases

emboli in submucosal vessels produced subnecrotizing ischaemia of all bowel layers which healed by cicatrizing fibrosis, resulting in stricture. The evolution of the changes within vessels was first elucidated in rabbits (Flory 1945): the vessels were initially plugged by cholesterol crystals and amorphous debris, and a foreign body giant cell reaction was followed by concentric intima1 fibrosis and luminal reduction; recanalization was limited. Meyer (1947) suggested that the sharp crystals penetrate the internal elastic lamina and media, with subsequent spasm pushing them through the vessel wall into the perivascular connective tissue. Spontaneous atheromatous embolism should be considered in the differential diagnosis of small bowel stricture, particularly in elderly patients with a previous history of atheroma-associated disease.