AORTITIS SYNDROME WITH PROTRACTED CLINICAI COURSE

Abstract

A comparative histopathological study of aortitis syndrome was performed in terms of the duration of illness. Five autopsy cases were divided into two groups, three short term cases and two long term cases. The aortic lesions of the short term group were characterized by the presense of pathognomonic granulomatous inflammation. These consisted of epithelioid cell granuloma including multinucleated giant cells and dense infiltration of lymphocytes and plasma cells. There was no atherosclerotic change in the intima. On the other hand, the aortae of the long term group showed severe atherosclerotic change in the intima. Their lumens were dilated, even forming a large abdominal aneurysm in one case. Fibrosis, loss of smooth muscle cells and elastic fibers, and splitting of the inner aspect were frequently observed in the media. There was a dense fibrosis in the adventitia. It is suggested that the formation of a slit-like space in the inner half of the media represents a characteristic lesion of aortitis of longer duration. Improvement in chemotherapeutic regimens, including corticosteroid therapy, might be responsible for the favorable prognoses seen in the long term group.