In Reply: Drs Charlier and Huynh propose that mediasclerosis is a unique disease, manifest as calcification of the tunica medica, a disease completely different from atherosclerosis, which they presumably would define exclusively as a disease of the intima. We believe that atherosclerosis is a multifaceted, systemic disease that encompasses both of these histologic features. The earliest pathologic manifestations of atherosclerosis include intimal thickening and fatty streaks, but complex changes occur as the disease progresses, with structural remodeling of the vessel, cellular infiltrates, lipid accumulation, thrombosis, fibrosis, and calcification involving the media as well as the adventitia.1
Thomas GS. Assessment of Atherosclerosis in Egyptian Mummies—Reply. JAMA. 2010;303(12):1149–1150. doi:10.1001/jama.2010.327
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