In contrast to previous CAP protocols, where all forms of blood and lymphatic invasion were grouped under a single term, lymph-vascular invasion, the updated protocol (version 4.0.0.1 and later) includes separate categories for small vessel invasion (including lymphatics, capillaries, and
postcapillary venules) and large vessel (venous) invasion, and for EMVI and intramural VI.
All types of the disease share the same clinical presentation due to unregulated generation of bradykinin causing leakage of plasma from
postcapillary venules (5-7).
These telangiectasias, the hallmark of the disease, arise from the dilatation of
postcapillary venules, which directly fuse with an arteriole, thus bypassing the capillary system.
Furthermore, the previous studies showed that SP induced neutrophil infiltration in rat mesenteric
postcapillary venular endothelium by MC-activated (24).
The excessive accumulation of neutrophils in the
postcapillary venules during inflammation causes clogging of the vessels; therefore, there is a decrease in tissue perfusion (3).
Postcapillary venules drain caudally into veins of the posterior group of the medial nasal glands (Figs.
Atherosclerotic lesions recruit inflamed endothelial cells in
postcapillary venues, such as intracellular adhesion molecule-1, E-selectin, and vascular cell adhesion molecule-1.
Senile hemangioma or CA is a vascular tumor which consists of proliferated small vascular channels which have been originated from
postcapillary venules in the upper dermis and it has been mentioned that CA should not be considered as a neovascularization [5].
Also, it is well accepted that Th2-derived interleukin-5 (IL-5) plays a key role in developing and maturing of eosinophils, enhancing their adhesion to endothelial cells lining the
postcapillary venules, activating, secreting, and prolonging survival through apoptosis inhibition in the tissues [16].
Postcapillary PH is defined as PH due to left ventricular dysfunction (either myocardial and/or valvular) when PAWP is >15mmHg [2, 3].
The 2015 European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of PH further separated PH-LHD into isolated
postcapillary PH and mixed pre- and
postcapillary PH.
We supposed that the
postcapillary levels of the pulmonary veins would have been obstructed in this case because the stenosis at the surgical anastomosis and accelerated blood flow of pulmonary veins were not detected.