Consensus statement on the processing, interpretation and reporting of temporal artery biopsy for arteritis

Area of Science:

• Rheumatology
• Pathology
• Vascular Medicine

Background:

• Giant cell arteritis (GCA) is the most prevalent systemic vasculitis in adults in Europe and North America.
• It commonly affects extra-cranial branches of carotid arteries and the thoracic aorta.
• Temporal artery biopsy (TAB) is the gold standard for GCA diagnosis, despite advances in noninvasive imaging.

Purpose of the Study:

• To establish consensus guidelines for the processing, interpretation, and reporting of TAB specimens.
• To address the lack of uniformity in TAB analysis among pathologists.
• To provide a standardized approach for diagnosing GCA via TAB.

Main Methods:

• A committee formed by the Society for Cardiovascular Pathology reviewed existing literature.
• Consensus was developed for TAB processing, interpretation, and reporting protocols.
• Differential diagnoses, including other arteritis forms and noninflammatory changes, were discussed.

Main Results:

• Lack of uniformity in TAB processing and interpretation exists.
• Guidelines are proposed to standardize TAB analysis.
• Differential diagnoses are outlined to aid pathologists.

Conclusions:

• Standardized guidelines for temporal artery biopsy are crucial for consistent GCA diagnosis.
• Adherence to consensus protocols will improve diagnostic accuracy and reporting.
• The guidelines will assist pathologists in differentiating GCA from other temporal artery conditions.