The tunica media comprises a single layer of endothelial cells supported by a basement membrane. Intimal thickening can be circumferential or focal. It is caused by: (1) hyperplasia, (2) Intimal fibrosis or (3) oedema.
Intimal thickening can result in narrowing of the lumen, and in extreme cases, luminal occlusion.
This image shows asymmetrical intimal thickening. On high power, the intima has a loosely, oedematous appearance. The lumen is narrowed by >50%.