Corcoran G M, Prayson R A, Herzog K M
Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA.
Am J Clin Pathol. 2001 Mar;115(3):342-7. doi: 10.1309/L8HF-VM0Q-F55E-5M83.
We retrospectively compared 81 temporal artery biopsy specimens demonstrating perivascular inflammation without evidence of temporal arteritis and 76 specimens demonstrating no inflammation. Patients with perivascular inflammation included 43 women (mean age, 71.2 years). Nineteen patients met the 1990 American College of Rheumatology (ACR) criteria for the diagnosis of temporal arteritis. All patients demonstrated chronic perivascular inflammation consisting primarily of lymphocytes. Granulomas were noted in 4 specimens. Internal elastic lamina disruption, intimal fibroplasia, and dystrophic calcification were noted in 86 arteries examined. Fibrosis or scarring of the vessel walls was observed in 10 specimens. Corticosteroid therapy was beneficial to 33 of 56 patients. In patients with no evidence of inflammation (50 women; mean age, 66.6 years), 21 met ACR criteria for temporal arteritis. Histologically, disruption of the elastic lamina was noted in 75 of 81 arteries biopsied, intimal fibroplasia in 66, microcalcifications in 5, and fibrosis or scarring in 5. In this group, 47 patients received corticosteroid therapy; clinical improvement was noted in 28. Patients with chronic perivascular inflammation but no arteritis seem no more likely to have temporal arteritis on clinical grounds than similar patients without inflammation on biopsy.
我们回顾性比较了81份显示血管周围炎症但无颞动脉炎证据的颞动脉活检标本和76份无炎症的标本。血管周围炎症患者包括43名女性（平均年龄71.2岁）。19名患者符合1990年美国风湿病学会（ACR）颞动脉炎诊断标准。所有患者均表现为主要由淋巴细胞组成的慢性血管周围炎症。4份标本中发现肉芽肿。在所检查的86条动脉中，有86条发现内弹力膜破坏、内膜纤维增生和营养不良性钙化。10份标本中观察到血管壁纤维化或瘢痕形成。皮质类固醇治疗对56例患者中的33例有益。在无炎症证据的患者（50名女性；平均年龄66.6岁）中，21例符合ACR颞动脉炎标准。组织学上，在81例活检动脉中，75例发现弹力膜破坏，66例发现内膜纤维增生，5例发现微钙化，5例发现纤维化或瘢痕形成。在该组中，47例患者接受了皮质类固醇治疗；28例患者临床症状改善。与活检时无炎症的类似患者相比，有慢性血管周围炎症但无动脉炎的患者临床上发生颞动脉炎的可能性似乎并不更高。
