Aortic Aneurysm Due to Microscopic Polyangiitis

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Presentation transcript:

Aortic Aneurysm Due to Microscopic Polyangiitis Masaaki Ryomoto, MD, Masataka Mitsuno, MD, Hiroyuki Nishi, MD, Shinya Fukui, MD, Yuji Miyamoto, MD, Hiroyuki Hao, MD The Annals of Thoracic Surgery Volume 88, Issue 6, Pages 2031-2034 (December 2009) DOI: 10.1016/j.athoracsur.2009.04.125 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) A skin biopsy specimen demonstrating acute necrotizing vasculitis of the small arteries in subcutaneous tissue. (B) Higher magnification of a small artery shows massive infiltration of leukocytes and marked destruction of the arterial wall. (C–E) Aneurysmal wall of the ascending aorta shows fibrous thickening of the adventitia and intima. Atrophy of the aortic media with destruction of elastic fibers is prominent. (F) Endarteritis obliteration of vasa vasorum in the adventitia. (A, B, and D: Hematoxylin & eosin; and C, E, and F: Elastica van Gieson; photomicrograph A and C shown at ×10, B and F at ×50, and D and E at ×100, respectively.) The Annals of Thoracic Surgery 2009 88, 2031-2034DOI: (10.1016/j.athoracsur.2009.04.125) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Preoperative computed tomographic scans are shown. (A) The aortic arch and descending aorta were of normal sizes. An aberrant left subclavian artery (asterisk) can be seen arising from the descending aorta. (B) The ascending aorta was severely enlarged to 5 cm in diameter. (C) The ascending aorta was enlarged from just above the sinotubular junction (STJ) (white line). The Annals of Thoracic Surgery 2009 88, 2031-2034DOI: (10.1016/j.athoracsur.2009.04.125) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions