(Circulation. 1998;98:1823.)
© 1998 American Heart Association, Inc.
Images in Cardiovascular Medicine |
Inflammatory Abdominal Aortic Aneurysm
Yuzuru Sakakibara, MD;
; Mikio Doy, MD
From the Department of Surgery, Institute of Clinical Medicine,
University of Tsukuba (Y.S.), and the Department of Pathology, Tsukuba Medical
Center Hospital (M.D.), Tsukuba Science City, Ibaraki, Japan.
Correspondence to Dr Y. Sakakibara, Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Science City, Ibaraki, 305, Japan.
A73-year-old
woman who had been losing weight progressively (-6 kg) over a period
of 6 months came to our hospital after experiencing growing abdominal
pain for 2 weeks. A CT of the abdomen revealed a 6-cm infrarenal
abdominal aortic aneurysm surrounded by a contrast-enhancing
mantel (Figure 1
). Her C-reactive protein
value was 4.3 mg/dL. Other laboratory tests revealed no specific
findings. The aneurysm was treated with a prosthetic
Y-graft through a transperitoneal approach. The characteristic white
glistening perianeurysmal fibrosis and severe thickening were
noted on the aortic and iliac arterial walls during
operation (Figure 2). Her postoperative
course was uneventful. Histopathological examination of the iliac
arterial wall was performed, and the dominant finding was
an inflammatory reaction with an infiltration of lymphocytes and plasma
cells in thickened, collagen-rich tissue (Figure 3). Plasmacytosis may play a causal role
in so-called inflammatory abdominal aortic
aneurysm.
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Figure 1. CT of abdomen.
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Figure 2. Periarterial thickening of common
iliac artery.
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Figure 3. Histopathological findings of aneurysmal
wall. M indicates media; A, adventitia.
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Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
