Comparison of clinical and pathological characteristics of isolated aortitis and Takayasu arteritis with ascending aorta involvement

Wang, Hongyue; Li, Li; Wang, Linlin; Chang, Qian; Pu, Jielin

doi:10.1136/jclinpath-2011-200424

Cited by 16 publications

(5 citation statements)

References 21 publications

(29 reference statements)

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“…If the inflammation is limited to the adventitia, then the term periaortitis is often employed. In studies involving primarily the thoracic aorta, noninfectious aortitis has been reported to involve from 2% to 16% of aortic resections [26,29,30,[47][48][49][50][51][52][53][54][55]. Aortitis is often an unexpected diagnosis at histological examination of surgically resected thoracic aneurysms and dissections, and may be the presenting feature of a systemic vasculitis or may occur in the absence of other clinical signs or symptoms of systemic vasculitis.…”

Section: Noninfectious Aortitis/periaortitismentioning

confidence: 96%

See 1 more Smart Citation

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Stone¹,

Bruneval²,

Angelini³

et al. 2015

Cardiovascular Pathology

266

232

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Inflammatory diseases of the aorta include routine atherosclerosis, aortitis, periaortitis, and atherosclerosis with excessive inflammatory responses, such as inflammatory atherosclerotic aneurysms. The nomenclature and histologic features of these disorders are reviewed and discussed. In addition, diagnostic criteria are provided to distinguish between these disorders in surgical pathology specimens. An initial classification scheme is provided for aortitis and periaortitis based on the pattern of the inflammatory infiltrate: granulomatous/giant cell pattern, lymphoplasmacytic pattern, mixed inflammatory pattern, and the suppurative pattern. These inflammatory patterns are discussed in relation to specific systemic diseases including giant cell arteritis, Takayasu arteritis, granulomatosis with polyangiitis (Wegener's), rheumatoid arthritis, sarcoidosis, ankylosing spondylitis, Cogan syndrome, Behçet's disease, relapsing polychondritis, syphilitic aortitis, and bacterial and fungal infections.

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Section: Noninfectious Aortitis/periaortitismentioning

confidence: 96%

“…In patients below the age of 50, Takayasu arteritis is the most common systemic vasculitis that afflicts the aorta [32,47,49,55,[65][66][67][68][69][70]. Takayasu arteritis primarily involves large elastic arteries, particularly the aorta and arch vessels.…”

Section: Takayasu Arteritismentioning

confidence: 99%

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Stone¹,

Bruneval²,

Angelini³

et al. 2015

Cardiovascular Pathology

266

232

View full text Add to dashboard Cite

show abstract

“…In a recent Chinese operation series, patients were younger and mostly male [50]. In an Italian study where diagnosis was made by PET with an isolated 18 FDG uptake to the aorta, 9/11 patients were male and age at diagnosis with a mean of 62 years was considerably below that of a comparative group of RCA patients [51].…”

Section: Isolated Aortitis (Ia)mentioning

confidence: 99%

Inflammatory diseases of the aorta

Caspary

2016

Vasa

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Summary:Infl ammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci or septicaemia and tend to result in the rapid development of aneurysms. Large vessel vasculitis due to Takayasu arteritis in younger and giant cell arteritis (GCA) in older patients is located in all layers of the aortic wall and prevails in the thoracic section. GCA patients are prone to developing aortic complications in the late course of disease. In Behçet's disease, aneurysms may have an unusual morphology and localisation. The diagnosis of aortitis is usually obtained by vascular imaging, but partly made only by biopsy on occasion of an operation, especially in case of isolated aortitis of the ascending aorta which mostly remains inapparent until dissection or large aneurysms have developed. Periaortitis typically occurs in the abdominal aorta and may lead to infl ammatory aortic aneurysm (IAA). It is looked upon as a special form of vasculitis, with an overlap to primary retroperitoneal fi brosis (RF). An identical pathology is discussed for the three diseases. On the other hand, about 50 % of isolated aortitides and periaortitides as well as retroperitoneal fi broses can be classed among IgG4-related diseases. Periaortitis also is observed after treatment of aortic aneurysms by stent-graft implantation. Special attention should be paid to ureteral obstruction along with RF or IAA. Once infection is ruled out, immunosuppression is applied to all forms of infl ammatory aortic diseases, primarily with glucocorticoids. However, after successful surgery for isolated thoracic aortitis or infl ammatory aortic aneurysm immunosuppression may be dispensable and it is not required if periaortic tissue enlargement persists in chronic inactive disease. For some patients with periaortitis and RF, tamoxifen may be a valuable alternative.

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“…At times, it is histologically compared to giant cell arteritis (GCA) (11). GCA is characterized by patchy areas of medial necrosis with infiltration of lymphocytes and plasma cells (1,2). Our patient did not have any areas of necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…While most forms of aortitis can be linked to a specific cause, patients with idiopathic aortitis (IDA), are asymptomatic and usually diagnosed after surgical removal. The specific pathophysiology is not well understood, but can be strongly associated with tobacco smoking, young age at presentation, and family history of aortic aneurysm (1).…”

Section: Introductionmentioning

confidence: 99%

Isolated idiopathic aortitis with an unusually thickened aortic wall: case report

et al. 2016

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Aortitis includes a broad range of disorders involving inflammation of the aorta. While most forms of aortitis can be linked to a specific cause, patients with idiopathic aortitis (IDA), are asymptomatic and usually diagnosed after surgical removal. The specific pathophysiology is not well understood, but can be strongly associated with tobacco smoking, young age at presentation, and family history of aortic aneurysm. Wall thickening is the most common physical characteristic of aortitis, and the inflammation can affect any layer of the aorta.The normal wall thickness of the aorta is less than 4 mm and can be as thick as 9 mm. Few studies document a correlation between wall thickness and the severity of aortitis. This paper presents a unique case of severe aortic aneurysm associated with an abnormal thickening of the ascending aorta.

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Comparison of clinical and pathological characteristics of isolated aortitis and Takayasu arteritis with ascending aorta involvement

Abstract: Cases of IA tend to have more histologically active inflammation except for a relatively normal erythrocyte sedimentation rate, localised lesions and milder intimal fibrosis than cases of TA. IgG4 abnormality may not be the main cause of IA.

Cited by 16 publications

References 21 publications

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Inflammatory diseases of the aorta

Isolated idiopathic aortitis with an unusually thickened aortic wall: case report

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