PHLEBOSCLEROSIS, PHLEBOTHROMBOSIS, AND THROMBOPHLEBITIS - A CURRENT PERSPECTIVE

Phlebosclerosis, phlebothrombosis, and thrombophlebitis are three fund amentally different structural changes affecting superficial, deep, vi sceral, and cerebral veins. Phlebosclerosis is a frequent, age-depende nt fibrotic degeneration of one or all three wall layers. It does not represent a distinct disease entity but may impair the venous function and contribute to the development of thrombosis. Phlebothrombosis rep resents a serious circulatory disorder. It may be due to a variety of factors including phlebitis, i.e., a primary inflammatory disease of t he venous wall. Thrombophlebitis may be a relatively harmless disorder , such as represented by idiopathic skipping phlebitis (phlebitis salt ans), or it may be a symptom of an underlying systemic disease. Wherea s phlebothrombosis in non-varicose veins is suspicious of an underlyin g malignancy or a coagulation disorder, thrombophlebitis is not relate d to malignancies but may accompany Buerger's disease or other systemi c vasculitides. The histopathological distinction of phlebothrombosis and thrombophlebitis is therefore of paramount importance and determin es further clinical investigations. A proposal for classification of t hrombophlebitides and some guidelines for clinicopathological differen tiation of the various types of phlebitides are presented.