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Giant cell arteritis in a patient with aortic dissection: a case report
Hiyo Obikane1, Toshiki Fujiyoshi2, Satoshi Takahashi2
1Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Summary
Giant cell arteritis, a large-vessel vasculitis, rarely presents with aortic dissection. This case highlights the importance of considering giant cell arteritis in patients with aortic dissection and specific histopathological findings.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Pathology
Background:
- Aortic aneurysms and dissections are known late complications of giant cell arteritis (GCA).
- Large-vessel vasculitis encompasses conditions like GCA and Takayasu arteritis (TA).
- Distinguishing between GCA and TA can be challenging, especially in rare presentations.
Observation:
- A 71-year-old male presented with acute back pain, diagnosed with Stanford type A aortic dissection.
- Surgical repair of the ascending aorta revealed histopathological evidence of aortic dissection and multinucleated giant cell granulomas.
- Granulomas were situated in the aortic media near the intima, with internal elastic lamina destruction.
Findings:
- The patient was diagnosed with GCA, a form of large-vessel vasculitis.
- Histopathological findings differed from Takayasu arteritis, notably lacking feeding vessel stenosis or adventitial fibrosis.
- The diagnosis of GCA in the context of aortic dissection is considered rare.
Implications:
- This case underscores the importance of considering GCA in the differential diagnosis of aortic dissection, particularly in older adults.
- Understanding the histopathological nuances between GCA and Takayasu arteritis is vital for accurate diagnosis.
- Further research may elucidate the specific mechanisms linking GCA to aortic dissection.
