CONTRACTION BANDS IN VISCERAL AND VASCULAR SMOOTH-MUSCLE

Smooth muscle contraction bands (SMCBs) have been described in the gas trointestinal tract, subsequent to acute ischemia, and in the coronary arteries of animals and individuals with a sudden death; in these cir cumstances SMCBs have been postulated to serve as a premortem marker, and suggested as diagnostically useful. The present investigation was undertaken to determine whether the presence of SMCBs could be correla ted with a premortem clinical condition. Retrospectively, the routinel y prepared histological sections from 76 autopsy and 93 surgical cases were screened semiquantitatively for the presence of SMCBs. The autop sy sections examined included the gastrointestinal tract, the prostate , and the coronary arteries, as well as all other smooth muscle-contai ning tissues; the surgical specimens included: coronary artery endarte rectomies; saphenous vein bypass grafts; temporal artery biopsies; pro static curettings; colectomies; varicose veins; leiomyomas of uterus, bowel, and skin; and, leiomyosarcomas. The clinical and pathology repo rts were reviewed for patient demographics, major clinical diagnoses, presence of shock, details of any resuscitation attempts, time interva l to postmortem, and the cause of death. SMCBs were evident in 100% of the gastrointestinal and prostate, and in 96% of the coronary artery autopsy sections examined. All surgical specimens were positive for SM CBs, the exceptions being leiomyomas (positive in 13 of 22; 60%) and l eiomyosarcomas (4 of 5; 80%); SMCBs in surgical specimens were less pr ominent when compared with those observed in autopsy tissue. No correl ation was found between the presence of SMCBs and any clinical or demo graphic parameter assessed, because of the virtual universal occurrenc e of the SMCBs. The presence of less distinct SMCBs in surgical specim ens may very well be artifactual, akin to myocardial and skeletal musc le contraction bands. The observation that SMCBs at autopsy are virtua lly ubiquitous suggests that they are best considered an agonal phenom enon, and a nonspecific pathological finding. Copyright (C) 1996 by W. B. Saunders Company