The lumbar sympathetic ganglia of ten atherosclerotic patients, six diabetics and four nondiabetics, were examined by light and electron microscopy. Giant neurons and vacuolation of the neurons were observed in the diabetic patients. Electron microscopy showed dilated endoplasmic reticulum cisterns with formation of large vacuoles. A few neurons were filled with membranous bodies. Axonal degeneration was observed. Blood vessels showed duplication of the basal membrane. The neuronal lesions are considered to represent primary effect of diabetes not related to blood vessel lesions. The sympathetic ganglia lesions may be responsible for the unsatisfactory results of sympathectomy in diabetics.
Kott I, Urea I, Sandbank U. Lumbar Sympathetic Ganglia in Atherosclerotic Patients, Diabetic and NondiabeticA Comparative Morphological and Ultrastructural Study. Arch Surg. 1974;109(6):787-792. doi:10.1001/archsurg.1974.01360060057015