Pomerance A, Yacoub M H, Gula G
Histopathology. 1977 Jul;1(4):257-76. doi: 10.1111/j.1365-2559.1977.tb01665.x.
In 63 resected thoracic aortic aneurysms, the commonest histological finding (45 cases, 71.4%) was cystic medionecrosis. These cases formed two groups, 29 with widespread fragmentation and loss of elastic tissue (elastopathy) and 16 cases without elastopathy who were older and included most of the 18 cases of dissecting aneurysms. Thirteen patients had the Marfan syndrome, 10 showing cystic medionecrosis with elastopathy, indistinguishable from the cases with no Marfan stigmata although partial 'dissections' were mainly found in the Marfan patients, Histological appearances ranged from normal to complete loss of media. Cystic changes in muscle fibres apparently preceded elastic fragmentation. Fourteen cases (22%) had aortitis: 4 were syphilitic and 3 of other known aetiology. In 7 patients the aetiology of the inflammatory process was unknown and appearances included granulomatous infarct-like lesions and necrotizing aortitis or changes indistinguishable histologically from syphilis.
在63例切除的胸主动脉瘤中，最常见的组织学表现（45例，71.4%）为囊性中层坏死。这些病例分为两组，29例有广泛的弹性组织碎裂和丧失（弹性组织病），16例无弹性组织病，后者年龄较大，包括18例夹层动脉瘤中的大多数。13例患者患有马方综合征，10例表现为伴有弹性组织病的囊性中层坏死，与无马方综合征体征的病例难以区分，尽管部分“夹层”主要见于马方综合征患者。组织学表现从正常到中层完全丧失不等。肌纤维的囊性改变显然先于弹性组织碎裂。14例（22%）有主动脉炎：4例为梅毒性，3例病因已知。7例患者炎症过程的病因不明，表现包括肉芽肿性梗死样病变、坏死性主动脉炎或组织学上与梅毒难以区分的改变。
