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Skip areas in temporal arteritis

D M Albert, M C Ruchman, J L Keltner

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |December 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Temporal arteritis (TA) biopsies were examined for "skip areas" of inflammation. While most specimens showed inflammation throughout, some exhibited localized areas lacking diagnostic granulomatous inflammation, confirming TA skip areas can occur.

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    Area of Science:

    • Vascular Pathology
    • Rheumatology
    • Histopathology

    Background:

    • Temporal arteritis (TA), a form of large-vessel vasculitis, is characterized by systemic inflammation.
    • Diagnosis often relies on characteristic findings in temporal artery biopsies.
    • The presence of "skip areas" lacking inflammation can complicate histological diagnosis.

    Purpose of the Study:

    • To investigate the occurrence and nature of "skip areas" in temporal artery specimens from patients with confirmed temporal arteritis.
    • To determine if inflammation is uniformly distributed or exhibits segmental variations in TA.

    Main Methods:

    • Histopathological examination of eleven temporal artery specimens from ten patients diagnosed with temporal arteritis.
    • Detailed analysis of tissue sections to identify the presence and extent of granulomatous inflammation, including epithelioid cells and giant cells.

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  • Comparison of inflamed segments with adjacent areas lacking characteristic inflammatory cell infiltrates.

    • Main Results:

    • Nine out of eleven biopsy specimens demonstrated granulomatous inflammation throughout their entire length.
    • Two specimens exhibited discrete "skip areas" with reduced or absent signs of inflammation (epithelioid cells, giant cells).
    • These "skip areas" showed either diffuse round-cell infiltration of the adventitia or were entirely devoid of inflammatory cells.

    Conclusions:

    • The study confirms that "skip areas" lacking typical granulomatous inflammation can be present in temporal artery biopsies from patients with temporal arteritis.
    • The findings highlight the potential for histological sampling errors due to segmental inflammation distribution.
    • Awareness of "skip areas" is crucial for accurate diagnosis and management of temporal arteritis.