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Intimal sarcoma in an inflammatory aneurysm after endovascular aneurysm repair
Nitin Garg, MBBS, MPH, Mark A. Lewis, MD, Joseph J. Maleszewski, MD, Manju Kalra, MBBS Journal of Vascular Surgery Volume 55, Issue 4, Pages (April 2012) DOI: /j.jvs Copyright © 2012 Society for Vascular Surgery Terms and Conditions
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Fig 1 Serial computed tomography (CT) scan for post-endovascular aneurysm repair (EVAR) follow-up. One-month postoperative follow-up demonstrating residual inflammatory “halo” (arrow) (A), which is completely resolved at 3 years with decrease in aneurysm sac size to 4.8 cm from 5.4 cm in anteroposterior (AP) diameter (B). A small type II endoleak (arrowhead) is demonstrated at 5-year follow-up CT with no change in sac size (C). A CT scan performed after onset of symptoms (D and E) demonstrating irregular fluid collection abutting the aorta (small arrow), anterior to inferior vena cava (IVC) (asterisk), and reappearance of inflammatory “halo” (E), although in a different location compared to the preoperative site. The aneurysm sac had increased in size to 6.3 cm in AP diameter. Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions
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Fig 2 Intraoperative photograph demonstrating the abdominal aortic aneurysm (AAA) with a densely adherent duodenum (A). Location of the para-aortic “fluid collection,” which proved to be high-grade intimal sarcoma (B). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions
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Fig 3 Histology image of the tissue adherent to the endograft that consists of infiltrating clusters of malignant epithelioid cells with hyperchromatic and pleomorphic nuclei and vague intracytoplasmic lumina (hematoxylin and eosin stain, ×100 [A] and ×200 [B]). Malignant cells exhibiting reactivity with (C) CD31 and (D) Fli-1 (×200). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions
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