1/22. Stanford type A aortic dissection in a hypertensive patient with atherosclerosis of aorta and aortitis.dissection of aorta is a serious condition; the main factors are hypertension and diseases of the connective tissue or of collagen. aortitis syndrome in combination with hypertension and atherosclerosis in association with ascending aortic dissection is rarely seen. We present the case of a 53-year-old hypertensive patient whose ascending aortic dissection was associated with pericardial effusion without rupture of the aorta and with pleural effusion. Several unusual aspects of transesophageal echocardiography are described. The intraoperative biopsy revealed inflammatory aortitis with mural hematoma, without giant cells. The literature concerning aortic dissection and aortitis is reviewed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. giant cell arteritis presenting with annuloaortic ectasia.Four cases of giant cell arteritis causing severe aortic regurgitation secondary to an aneurysm of the ascending aorta are described. In two cases, the nature of the aortic pathology could be suspected considering the past clinical evidence of temporal arteritis and/or polymyalgia rheumatica. In the two other cases, the cardiothoracic manifestations represented the onset of Horton disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/22. Abdominal aortic dissection due to idiopathic medial aortopathy in a 32-year-old Caucasian man.A case of dissection of the abdominal aorta in a 32-year-old Caucasian man associated with a histological diagnosis of granulomatous aortitis and a clinical diagnosis of idiopathic medial aortopathy is described. The relationship between giant cell "temporal" arteritis, Takayasu's disease and idiopathic medial aortopathy is discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/22. Large vessel involvement in ANCA-associated vasculitides: report of a case and review of the literature.Vasculitides are currently classified according to the size of the vessels involved and characteristic clinical and histopathologic findings. Antineutrophil cytoplasmic antibodies (ANCA) and other serologic tests have been used to further characterize small vessel vasculitides. Large vessel involvement in ANCA-associated small vessel vasculitides has been overlooked in the medical literature. Here, we report a case of fatal aortitis and aortic dissection in a patient with microscopic polyangiitis and review reported cases of large vessel involvement in ANCA-associated vasculitides since 1990. We have attempted to characterize this subgroup of patients. Large vessel disease in ANCA-associated vasculitis may present as stenosing large vessel arteritis, aneurysmal disease, aortic dissection, aortic rupture, aortic regurgitation, and death. Prominent perivascular inflammation may present as mediastinal, cervical or abdominal soft tissue masses. ANCA-associated large vessel disease should be considered in the differential diagnosis of these disorders. The epidemiologic, clinical and pathologic characteristics of these patients differ from those of the well-defined large vessel vasculitides such as giant cell (temporal) arteritis or Takayasu's arteritis. We suggest that large vessel involvement is part of the spectrum of ANCA-associated vasculitis rather than an overlap with other large vessel vasculitides. It occurs in both myeloperoxidase- and proteinase 3-positive patients with either Wegener's granulomatosis or microscopic polyangiitis, but has not been reported in churg-strauss syndrome. Large vessel vasculitis can precede small vessel vasculitis or occur in the absence of small vessel involvement. We hope this report will contribute to the ongoing development of classification systems for the vasculitic syndromes.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/22. Type IV thoracoabdominal aortic aneurysm with lymphoplasmacytic aortitis and cystic medial degeneration in a 32-year-old patient with marfan syndrome.aortitis identified in approximately 12% of all thoracoabdominal aneurysms. The most common subtype of inflammatory aortitis is giant cell aortitis, followed by lymphoplasmacytic aortitis. Inflammatory aortitis may occur in isolation or as part of a systemic inflammatory disorder such as takayasu arteritis, systemic lupus erythematosus, rheumatoid arthritis, and giant cell arteritis. aortitis has not been described in patients with marfan syndrome. We report the case of a 32-year-old man with marfan syndrome and a strong family history of aneurysmal disease who presented with an asymptomatic Crawford type IV thoracoabdominal aneurysm. His aneurysm had no associated dissection, and surgical pathology revealed severe medial degeneration and lymphoplasmacytic aortitis. To our knowledge, this is the first report of such a finding in a patient with marfan syndrome.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/22. giant cell arteritis presenting with aortic dissection: two cases and review of the literature.aortitis is the most serious location of the disease giant cell (temporal) arteritis (GCA). Aortic dissection or the rupture of an aortic aneurysm can be responsible for sudden death among patients with GCA. This report discusses two cases of GCA presenting with aortic dissection. One case had histologically proven giant cell aortitis. The second case was a fatal aortic dissection preceded by a stroke. We describe the main features of aortic dissection and aortitis during GCA, reviewing the existing literature on this subject, and focusing on the requirement of prospective aortic imaging studies to screen patients with this kind of location.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
7/22. Thoracic aortic aneurysm associated with aortitis--case reports and histological review.Ten cases of post-inflammatory aneurysm of the thoracic aorta were studied morphologically using aortic wall and aortic valve tissue resected during the surgical repair of the lesions. Four cases of aortic aneurysm in Behcet's disease showed massive perivascular infiltration of the lymphocytes and plasma cells in adventitia and vasa vasorum. Fibrous obliteration of the vasa vasorum was seen, and neutrophilic infiltration was also associated in two cases with recurrent prosthetic valve failure. Three cases of aortic aneurysm associated with Takayasu's arteritis showed similar histologic features, but giant cells and histiocytic reactions were additional findings. Plasma cell infiltration was more pronounced compared to the Behcet's aortitis. One case of luetic aortitis showed a non-specific chronic inflammatory reaction with florid endothelial cell proliferation. One case of ankylosing spondylitis showed fibrous thickening at the periannular portion of the aortic valve cusps, but this finding was also seen in an aortic valve of a patient with Behcet's disease. One case without any disease association showed similar features of chronic inflammation with granuloma formation. The findings suggest that they have similar histologic features indistinguishable in terms of the clinical disease association, but a granulomatous reaction could be expected in Takayasu's arteritis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/22. Granulomatous aortic valvulitis associated with aortic insufficiency in Takayasu aortitis.We report an unusual case of Takayasu aortitis associated with a giant cell granulomatous valvulitis presenting with aortic insufficiency. Although nonspecific valvular abnormalities have been reported with Takayasu aortitis, this case is the first to describe involvement of the aortic valve by the disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/22. review of isolated ascending aortitis: differential diagnosis, including syphilitic, Takayasu's and giant cell aortitis.The image of tree-barking and proximal aortic root dilatation is firmly entrenched in the minds of practising pathologists as representing syphilis until proven otherwise. We discuss the differential diagnosis of syphilitic aortitis, Takayasu's disease, and giant cell aortitis, with a review of the literature and brief overview of other types of aortitis. As a starting point, we report a case of non-specific, or idiopathic, aortitis with aneurysm that was initially misdiagnosed as syphilitic aortitis. We then review the literature and emphasise the lack of histological data and histopathological criteria for the diagnosis of non-infectious aortitis and the implications for treatment in cases of isolated aortitis. Tree-barking is a non-specific finding in aortitis of any aetiology, and syphilitic aortitis in developed countries is rare. It is still unclear if there are histological features that separate Takayasu's disease and giant cell arteritis. In the majority of patients presenting with aortic root aneurysms, aortitis is an isolated finding not associated with autoimmune disease. Despite a plethora of literature, a histological classification of aortitis has yet to be attempted.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
10/22. Antemortem diagnosis of giant cell aortitis.A 67-year-old man well while receiving steroid therapy for giant cell arteritis, developed symptoms of ischemic heart disease and was found to have critical left main coronary stenosis. An aortic biopsy at the time of bypass grafting revealed giant cell aortitis. We discuss the finding of clinically discordant aortitis; the etiology of the concurrent coronary stenosis and therapy with prednisone-dapsone.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
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