Clinicopathologic study of inflammatory diseases of the aorta: A single-center experience

Aortic diseases contribute substantially to morbidity and mortality through inflammatory and degenerative mechanisms, yet existing classification schemes for inflammatory aortic pathology have limitations in the surgical pathology setting. This study aimed to characterize inflammatory diseases of the aorta using a standardized consensus-based reporting system. A retrospective cross-sectional review of archival aortic surgical pathology cases from 2009 to 2016 was performed, with histologic evaluation using elastic and trichrome stains and classification according to the Society for Cardiovascular Pathology-Association for European Cardiovascular Pathology consensus statement. Among 170 cases (mean age 61.9 years; 72% male), atherosclerosis predominated (86.5%), followed by aortitis/periaortitis (12.9%) and atherosclerosis with excessive inflammation (2.4%). Severe atherosclerosis accounted for 65.3% of cases, with frequent calcification and plaque disruption. Lymphoplasmacytic inflammation was the most common pattern of aortitis/periaortitis. Application of the consensus grading system enables standardized and reproducible characterization of inflammatory aortic diseases and supports its routine use in surgical pathology practice.