Lines of Zahn explained

Lines of Zahn
Specialty:	Pathology
Causes:	Thrombosis

Lines of Zahn are a characteristic of thrombi. They have layers, with lighter layers of platelets and fibrin, and darker layers of red blood cells. They are more present on thrombi formed with faster blood flow, more so on thrombi from the heart and aorta. They are only seen on thrombi formed before death. They are named after German–Swiss pathologist Friedrich Wilhelm Zahn.

Definition

Lines of Zahn are a characteristic of thrombi.^[1] They have visible and microscopic alternating layers (laminations).^{[2] [3]} Platelets mixed with fibrin form lighter layers. Red blood cells form darker layers. Sometimes, the term "lines of Zahn" only refers to the lighter layers.^[4]

Evaluation

Lines of Zahn can be used to confirm diagnosis of a thrombus. Their presence implies thrombosis at a site of rapid blood flow that happened before death. They are more common in thrombi formed in the heart or aorta.^[5] In veins or smaller arteries, where flow is not as constant, they occur less frequently. They are also only seen on thrombi formed when blood is flowing. This is a distinguishing marker between thrombi that formed before death and after death.

History

Lines of Zahn are named after German–Swiss pathologist Friedrich Wilhelm Zahn.

Further reading

• Book: Kumar V, Abbas AK, Fausto N . Robbins & Cotran Pathologic Basis of Disease . 2005 . 7th . Pennsylvania . Elsevier/Saunders . 978-0-7216-0187-8.
• Book: Underwood's pathology : a clinical approach. Churchill Livingstone. Edinburgh. 978-0-7020-4672-8 . 6th . Cross SS . Chapter 6: Thrombosis, Embolism and Infarction. 2013.

Notes and References

1. Book: https://www.sciencedirect.com/science/article/pii/B9780120777501500155. Thrombosis and Bleeding Disorders - Theory and Methods. Academic Press. 1971. 978-0-12-077750-1. 488–534. en. 11 - Thrombosis. 10.1016/B978-0-12-077750-1.50015-5.
2. Lee R, Adlam D, Clelland CA, Channon KM . Lines of Zahn in coronary artery thrombus . European Heart Journal . 33 . 9 . 1039 . May 2012 . 22345124 . 10.1093/eurheartj/ehs028 . free .
3. Saha P, Humphries J, Modarai B, Mattock K, Waltham M, Evans CE, Ahmad A, Patel AS, Premaratne S, Lyons OT, Smith A . 6 . Leukocytes and the natural history of deep vein thrombosis: current concepts and future directions . Arteriosclerosis, Thrombosis, and Vascular Biology . 31 . 3 . 506–512 . March 2011 . 21325673 . 3079895 . 10.1161/ATVBAHA.110.213405 .
4. Stone J, Hangge P, Albadawi H, Wallace A, Shamoun F, Knuttien MG, Naidu S, Oklu R . 6 . Deep vein thrombosis: pathogenesis, diagnosis, and medical management . Cardiovascular Diagnosis and Therapy . 7 . Suppl 3 . S276–S284 . December 2017 . 29399531 . 5778510 . 10.21037/cdt.2017.09.01 . free .
5. Heo JH, Nam HS, Kim YD, Choi JK, Kim BM, Kim DJ, Kwon I . Pathophysiologic and Therapeutic Perspectives Based on Thrombus Histology in Stroke . Journal of Stroke . 22 . 1 . 64–75 . January 2020 . 32027792 . 7005358 . 10.5853/jos.2019.03440 .