Isolated thoracic aortitis: clinicopathological and immunohistochemical study of 11 cases

Laco, Ján; Steiner, I; Holubec, Tomáš; Dominik, Jan; Holubcová, Zdeňka; Vojacek, Jan

doi:10.1016/j.carpath.2010.09.003

Cited by 42 publications

(41 citation statements)

References 24 publications

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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%

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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

268

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%

“…IgG4-RD is a recently recognized disease that may be associated with aortitis or periaortitis [31,32,41,52,53,99]. IgG4-RD is characterized by elevated serum levels of IgG4 and histopathological findings including fibrosis and prominent tissue infiltration by lymphocytes and IgG4-positive plasma cells.…”

Section: Igg4-related Diseasementioning

confidence: 98%

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

268

232

View full text Add to dashboard Cite

show abstract

“…Laco et al found the typical histological aspect with numerous plasmocytes staining for IgG4 in 6 out of 11 patients [57]. Agaimy et al detected lymphoplasmacytic infi ltrates in a high number of specimens among 15 out of 376 patients operated for thoracic aortic aneurysms.…”

Section: Igg4-related Aortitismentioning

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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“…the other conditions are sclerosing cholangitis, chronic sclerosing sialadenitis (Mikulicz disease), mediastinal and retroperitoneal fibrosis (Ormond's disease), inflammatory pseudotumors of the liver, lung, orbita and others (6). also large vessel involvement has been recognized as an igg4 -related disease -isolated thoracic aortitis, periaortitis, inflammatory abdominal aortic aneurysm (7,11). the mediastinal mass in our patient was in close contact with thoracic aorta, the small masses were in contact with aortic arch and bifurcation of abdominal aorta, respectively.…”

Section: Pathological Findingsmentioning

confidence: 92%

Case 1‑2012: ANCA Associated Glomerulonephritis in Combination with IgG4 Positive Mediastinal Mass in a Patient with Ankylosing Spondylitis Treated with TNF Alpha Inhibitors

Tošovský

Bradna

Laco

et al. 2012

Acta Med. (Hradec Kralove, Czech Repub.)

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Isolated thoracic aortitis: clinicopathological and immunohistochemical study of 11 cases

Cited by 42 publications

References 24 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

Case 1‑2012: ANCA Associated Glomerulonephritis in Combination with IgG4 Positive Mediastinal Mass in a Patient with Ankylosing Spondylitis Treated with TNF Alpha Inhibitors

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