This high magnification of the atheroma shows numerous foam cells and an occasional cholesterol cleft. A few dark blue inflammatory cells (lymphocytes) are scattered within the atheroma.

Increasing accumulation of foam cells in an atheroma can predispose to development of a necrotic core, enhanced by plaque hemorrhage. Larger necrotic cores often have a thin overlying fibrous cap prone to rupture. Plaque rupture can lead to thrombosis, as can endothelial erosion.