1/18. giant cell arteritis localized to the colon associated with Crohn's disease.AIMS: Intestinal vasculitis is uncommon and usually accompanies systemic vasculitis. Although intestinal vascular changes including vasculitis have been studied intensively, and are found regularly in Crohn's disease, giant cell arteritis is distinctly unusual. We describe a case of giant cell arteritis localized to the colon of an 18-year-old girl suffering from Crohn's disease. methods and RESULTS: After three years of medical treatment, the patient underwent a proctocolectomy. The medium-sized arteries of the mesocolon demonstrated striking changes characterized by intimal fibrous thickening and an inflammatory infiltrate with giant cells, most predominant at the intima-media junction. epithelioid cells and sarcoid-like granulomas were not observed. The internal elastic lamina was fragmented. Neither clinical symptoms nor laboratory findings showed evidence of systemic vasculitis. Neither the chest CT scan nor the echo-Doppler of the temporal arteries, supra-aortic and abdominal vessels revealed any abnormality. CONCLUSIONS: This case illustrates an extremely rare feature in the spectrum of vascular lesions in Crohn's disease which have to be differentiated from temporal and Takayasu's arteritis.- - - - - - - - - - ranking = 1keywords = intima (Clic here for more details about this article) |
2/18. radiation arteritis following treatment for Wilms' tumor: an unusual case of weight loss.Wilms' tumor is the most common pediatric primary renal cancer and is highly responsive to surgery and chemotherapy. The role of radiotherapy has evolved in the last three decades from the use of stepwise incremental doses in all patients to the current concept of added radiotherapy in advanced cases or in those with unfavorable pathology. To the authors' knowledge, this is the first case of a young woman with prior history of Wilms' tumor and significant weight loss due to radiation arteritis involving the abdominal vasculature. A 31-year-old woman presented with a history of weight loss and severe malnutrition. An angiogram revealed that the aorta was occluded below the renal artery. The celiac artery and the superior mesenteric artery were occluded at the origin, and large intercostal collaterals reconstituted the pelvic circulation. She was initially treated with total parenteral nutrition (TPN) and underwent an infrarenal aortic bypass surgery. Histopathology of the aorta revealed intimal fibrocalcific thickening and changes consistent with radiation-induced arteritis. Later, she was readmitted with progressive hepatic insufficiency. Despite intensive medical therapy, she died of multi-organ failure.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
3/18. Death from spontaneous coronary artery dissection in a healthy postmenopausal woman.Spontaneous dissection of the coronary arteries, in the absence of trauma, is an unusual but well-documented entity that occurs usually in middle-aged women. It is a rare cause of sudden death and myocardial infarction. Coronary eosinophilic arteritis is suggested to result in a predisposition to intimal disruption and dissection. We present the case of the sudden death of a previous healthy, 53-year-old postmenopausal female, while working, in a town of Thessalia in greece. The cause of death was left anterior descending coronary dissection with histologic findings of eosinophilic arteritis and autoimmune thyroiditis.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
4/18. Segmental mediolytic arteritis. Clinicopathologic study and three-dimensional analysis.We describe the first recorded case of segmental mediolytic arteritis (SMA) in japan. A 71-year-old Japanese woman developed sudden abdominal pain and went into shock during hospitalization for treatment of valvular heart disease. laparotomy revealed a ruptured pseudoaneurysm of the left gastric artery. Histological examination of the resected artery revealed multiple extensive areas of the dilated wall where the media had partially or totally disappeared with or without the intima. These features were typical of those described previously for SMA (1,2). Three-dimensional analysis of the arterial lesions revealed that the residual media formed branches and cavities down the long axis of the artery, indicating that the major cause of the medial disappearance was arterial dissection. Three months later, the patient died of sepsis. autopsy revealed pseudoaneurysm formation at three different locations in the splenic artery. Histologically, these pseudoaneurysms showed destructive changes in the arterial wall similar to those described above, with organization and thrombosis, and were considered to be the end-stage lesion of SMA. This case is considered to be the fifth adult case of SMA in the literature and the first one showing chronic changes.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
5/18. Segmental mediolytic arteritis involving hepatic arteries.Segmental mediolytic arteritis is a rare, noninflammatory arteriopathy that involves the splanchnic arteries of adults with shock and the coronary arteries of neonates with hypoxemia. We report the first case (to our knowledge) of segmental mediolytic arteritis involving the hepatic arteries. The lesion begins with cytoplasmic vacuolar degeneration of the arterial smooth-muscle cells, which then progresses to coalescence of vacuoles, leading to disruption of the media, intramural hemorrhage, and periadventitial fibrin deposition. Segmental mediolysis results in arterial wall defects, which can lead to dissecting aneurysms or hemorrhage due to arterial rupture. The intima and internal elastica are spared from the lytic process, and there is minimal periadventitial inflammation. Segmental mediolytic arteritis is not a true arteritis; therefore, segmental mediolytic arteriopathy may be a preferable term. Morphological similarities exist between segmental mediolytic arteritis and arterial fibromuscular dysplasia. In our case, hepatic ischemia correlated with mediolysis involving the hepatic arterial branches. Segmental mediolytic arteritis is thought to be due to an inappropriate vasospastic response, developing in the setting of hypoperfusion and hypoxemia.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
6/18. Coronary arterial pathology in the transplanted human heart.The coronary arteries of 23 transplanted human hearts have been studied following death or re-transplantation, 8 days to 8 years after surgery, with a view to defining the sequence of changes in the first months. Occlusive arteritis occurs in association with acute rejection. Intimal hyperplasia, usually accompanied by disruption of the internal elastic lamina and proliferation of smooth muscle cells, may be seen within two weeks. lipids and mucopolysaccharides appear in the thickened intima only after about 2 months. The end-state of the process is atherosclerosis, indistinguishable from that of the non-transplanted heart: for this to occur the patient must survive long enough, and therefore the early coronary occlusive process must not be too vigorous. It is unlikely that there are two different diseases of the transplanted coronaries, "chronic rejection" and "atherosclerosis". The apparent difference between these is due to the absence or presence of lipid, which is a function of time. In the transplanted heart, lipid is not an inciting factor in the arteriopathy. In this, the role of mitogens would appear to be critical.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
7/18. Periarteritis of coronary arteries with severe eosinophilic infiltration. A new pathologic entity (eosinophilic periarteritis)?A 40 year-old male presented symptoms of angina pectoris for about nine years and expired with symptoms of unstable angina, changing pattern at the terminal stage. At autopsy, both right and left coronary arteries of the subepicardial region were grayish white and elastic hard. Histologically, inflammatory infiltration was localized in adventitia of coronary arteries located in the subepicardial region. Inflammatory cells infiltrated into the adventitia were mostly eosinophiles. The medial smooth muscle cells were well preserved and the intima showed irregular thickening with fibrosis. Vascular obstruction or recanalization could not be observed. As a result of these findings, it was considered that these inflammatory changes of the coronary arteries could be termed eosinophilic periarteritis. These inflammatory changes could not be found in the intramural coronary arteries. Rather extensive fibrosis could be seen in the muscle layer centering about the posterior wall of the left ventricle. No findings of angiitis could be detected in the blood vessels except subepicardial coronary arteries.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
8/18. Mycobacterial coronary arteritis in a heart transplant recipient.A case of mycobacterial vasculitis in a chronically rejected transplanted heart is described. The coronary arteries were the only vessels involved by mycobacteria, although the patient had a generalized infection. The process of chronic rejection, with persistent injury to the intimal vascular lining of a transplanted organ, may lead to defects in the endothelial cell barrier and thus facilitate infiltration of a vessel wall by acid-fast bacilli.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
9/18. Occlusive coronary arteritis: a cause of early death in a cardiac transplant patient.A patient died 5 months after undergoing cardiac transplantation. Endomyocardial biopsies performed prior to death showed no evidence of severe rejection. At autopsy, nonnecrotizing occlusive coronary arteritis was present. The intima of the coronary arteries contained numerous lymphocytes and plasma cells. Chronic rejection appeared to be responsible for the arteritis. The onset of coronary occlusive disease is insidious, and recognition depends on the performance of coronary arteriography, which is usually not done until the one-year follow-up. Early coronary arteriography is suggested to rule out occlusive coronary arteritis when cardiac allograft function is not satisfactory, even when the endomyocardial biopsy shows no evidence of rejection.- - - - - - - - - - ranking = 0.5keywords = intima (Clic here for more details about this article) |
10/18. Hemorrhagic infarctions of testis due to intimal fibroplasia of spermatic artery.Two cases of hemorrhagic infarctions of the testis are presented. The infarctions were due to intimal fibroplasia of the branches of the spermatic artery; to our knowledge, a condition described only in the kidney. The differences between intimal fibroplasia and the lesions of polyarteritis nodosa and thromboangiitis obliterans are discussed.- - - - - - - - - - ranking = 3keywords = intima (Clic here for more details about this article) |
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