Department of Pathology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
Pathol Int. 2021 Mar;71(3):204-209. doi: 10.1111/pin.13046. Epub 2021 Jan 27.
Giant cell arteritis (GCA) is a systemic vasculitis affecting mainly large and medium-sized arteries. GCA sometimes involves the aorta and its major branches and causes aortic dissection as a rare complication. We have experienced an autopsy case of aortic dissection due to GCA. The patient was an 87-year-old Japanese woman with Stanford type A aortic dissection who died 7 days after admission. Two years previously she had been diagnosed as having abdominal aortic aneurysm and undergone endovascular aneurysm repair (EVAR). Although she had no characteristic symptoms of GCA, autopsy revealed marked granulomatous inflammation in the dissected area and coronary arteries. Active arteritis was evident not only in the arteries of the upper extremity but also those in the lower extremity. Granulomatous inflammation was not evident in the aneurysm. The aortic dissection might have been an initial manifestation of GCA. We report the regions of GCA extension and its histology in detail.
巨细胞动脉炎（GCA）是一种主要影响大中动脉的系统性血管炎。GCA 有时累及主动脉及其主要分支，并导致罕见的并发症——主动脉夹层。我们曾遇到过一例因 GCA 导致的主动脉夹层病例。该患者是一位 87 岁的日本女性，患有 Stanford 型 A 型主动脉夹层，入院后 7 天死亡。两年前，她被诊断为腹主动脉瘤，并接受了血管内动脉瘤修复术（EVAR）。尽管她没有 GCA 的典型症状，但尸检显示在夹层区域和冠状动脉中存在明显的肉芽肿性炎症。不仅上肢动脉，下肢动脉也有明显的动脉炎。动脉瘤中没有明显的肉芽肿性炎症。主动脉夹层可能是 GCA 的初始表现。我们详细报告了 GCA 的扩展区域及其组织病理学。
