1. Clinical-pathologic conference in thoracic surgery: Proximal pulmonary artery obstruction secondary to Takayasu arteritis 
Thoralf M. Sundt, MD 
The Journal of Thoracic and Cardiovascular Surgery 
Volume 121, Issue 1, Pages (January 2001)
DOI: /mtc
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

2. Fig. 1
Posterior pulmonary perfusion image in August 1999 demonstrates globally decreased perfusion of the right lung. The ventilation images (not shown) were normal.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

3. Fig. 2
Posterior pulmonary perfusion image in December 1999 shows decreased perfusion of the right lung. A segmental perfusion defect (arrow) is also noted in the apical subsegment of the left upper lobe.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

4. Fig. 3
and 4. The superior vena cava (V) is dilated. Focal narrowing and thickening of the walls of the left pulmonary artery and right pulmonary artery (arrows) is seen. Thickening of the wall of the descending aorta (DA) is also noted. No pulmonary emboli are seen.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

5. Fig. 5
Continuous wave Doppler TEE before repair depicting tricuspid regurgitation. The estimated right ventricular end-systolic pulmonary artery pressure is 66 mm Hg.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

6. Fig. 6
Continuous wave Doppler TEE before repair of the hepatic veins. The systolic (S) to diastolic (D) ratio is greater than 1.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

7. Fig. 7
Continuous wave Doppler TEE after repair. The tricuspid regurgitation jet is significantly reduced. The estimated systolic pulmonary artery pressure is 24 mm Hg.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

8. Fig. 8
Continuous wave Doppler TEE after repair of the hepatic venous flow (HVF). The systolic/diastolic (S/D) ratio is now less than 1.0.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

9. Fig. 9
Operative photograph shows the separate ringed PTFE grafts from the main pulmonary artery to the right and left pulmonary arteries (head is to the left).
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

10. Fig. 10
Tissue submitted for frozen sections showed inflammatory cells in arterial media; the tracking of inflammatory cells between the elastic and muscular layers imparts a “striped” appearance.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

11. Fig. 11
Additional frozen section tissue showed inflamed fibrous tissue, as well as the presence of systemic capillaries.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

12. Fig. 12
Sections of the intra-arterial tissue showed inflamed fibrous tissue, as well as foamy histiocytes.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

13. Fig. 13
Abundant plasma cells were present within the media; typical features of plasma cells include an eccentric nucleus, amphophilic cytoplasm, and perinuclear halos.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

14. Fig. 14
Necrosis with abscess-like pattern, including neutrophils in the necrotic debris. There is a surrounding palisade of histiocytes.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

15. Fig. 15
A higher power view shows necrotic and purulent debris, with surrounding histiocytes and giant cells. There is a serpentine elastic fiber with the necrotic debris (arrow).
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc )
Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions