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Diabetic microangiopathy and necrotizing vasculitis

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Upper panel: Thionine blue-stained section of nerve showing an endoneurial capillary with thickened wall and red cell (R) seepage in the endoneurium. Note the marked reduction in density of myelinated nerve fibers. Lower panel: Hematoxylin and eosin-stained longitudinal section of a paraffin-embedded nerve showing mononuclear inflammatory infiltrate around and within the wall of an epineurial blood vessel. Significant endoneurial hemorrhage is present (H). Note that the nerve fibers are undergoing axonal degeneration. (Said G, et al. Inflammatory vasculopathy in multifocal diabetic neuropathy. Brain 2003;126:376-85. By permission of Oxford University Press.)