Di Giacomo V, Fraioli A, Carmenini G, Schietroma M, Meloni F, Grossi F
Angiology. 1984 Aug;35(8):528-33. doi: 10.1177/000331978403500811.
A 64 year old woman complained of aches and stiffness of the neck and the shoulders with fever and E.S.R. increase. A nonsteroid anti-inflammatory treatment was unsuccessful. A clinical examination revealed absence of both radial pulses and presence of murmurs at level of the carotids. The angiographic findings confirmed an aortic arch syndrome with severe stenosis of the subclavian and axillary arteries. The diagnostic approach, in spite of a negativity of the temporal artery biopsy, was for systemic giant cell arteries with general manifestations of polymyalgia rheumatica. The biopsies of both subclavian arteries, performed during a surgery revascularization, showed a typical giant cell arteries in acute stage. The histopathological pattern of extratemporal giant cell arteries obtained by means of a surgical biopsy is really uncommon, being the previous reports performed on necroscopic findings only. In addition this case confirms that polymyalgia rheumatica implies a systemic arteries even if the clinical and histopathological signs of temporal arteritis are lacking. Therefore the temporal artery should be only considered as a particular and inconstant localization of this vasculitis.
一名64岁女性主诉颈部和肩部疼痛、僵硬，伴有发热和血沉升高。非甾体抗炎治疗无效。临床检查发现双侧桡动脉搏动消失，颈动脉水平有杂音。血管造影结果证实为主动脉弓综合征，伴有锁骨下动脉和腋动脉严重狭窄。尽管颞动脉活检结果为阴性，但诊断方法仍考虑为伴有风湿性多肌痛全身表现的系统性巨细胞动脉炎。在手术血运重建过程中对双侧锁骨下动脉进行活检，显示为急性期典型的巨细胞动脉炎。通过手术活检获得的颞外巨细胞动脉的组织病理学模式非常罕见，此前的报告仅基于尸检结果。此外，该病例证实，即使缺乏颞动脉炎的临床和组织病理学体征，风湿性多肌痛也意味着系统性动脉受累。因此，颞动脉应仅被视为这种血管炎的一种特殊且不恒定的定位。
