Mikami Y, Kyogoku M
Kawasaki Medical School Hospital, Department of Surgical Pathology.
Nihon Rinsho. 1994 Aug;52(8):2148-51.
Inflammatory abdominal aortic aneurysm (IAAA) is a distinct clinicopathological entity, characterized by: (1) clinical presentation, such as back pain, weight loss, and increased ESR, (2) patchy and/or diffuse lymphoplasmacytic infiltration, and (3) marked periaortic fibrosis resulting in thickening of the aneurysmal wall and occasional retroperitoneal fibrosis. Its pathogenesis is unknown, but some authors support the theory that IAAA is a subtype of atherosclerotic abdominal aortic aneurysm because of close relationship between IAAA and atherosclerotic change. In this article, we describe clinical and histological features of IAAA on the basis of the literature and our review of 6 cases of IAAA, emphasizing the similarity and difference between IAAA and atherosclerotic abdominal aortic aneurysm. Our review supports that marked lamellar fibrosis completely replacing the media and adventitia, patchy lymphocytic infiltration (mostly B cells) and endarteritis obliterans are characteristic features of IAAA.
炎性腹主动脉瘤（IAAA）是一种独特的临床病理实体，其特征为：（1）临床表现，如背痛、体重减轻和血沉增快；（2）斑片状和/或弥漫性淋巴细胞浆细胞浸润；（3）显著的主动脉周围纤维化，导致动脉瘤壁增厚，偶尔出现腹膜后纤维化。其发病机制尚不清楚，但一些作者支持IAAA是动脉粥样硬化性腹主动脉瘤的一种亚型这一理论，因为IAAA与动脉粥样硬化改变之间关系密切。在本文中，我们根据文献以及对6例IAAA的回顾，描述了IAAA的临床和组织学特征，强调了IAAA与动脉粥样硬化性腹主动脉瘤之间的异同。我们的回顾支持，显著的板层状纤维化完全取代中膜和外膜、斑片状淋巴细胞浸润（主要为B细胞）和闭塞性动脉内膜炎是IAAA的特征性表现。
