Abstract
PurposeTo determine the appropriate number of histopathological cross-sections that are required for a conclusive diagnosis of giant cell arteritis (GCA).MethodsIn this cross-sectional study, the number of sections per slide for paraffin-embedded blocks for 100 randomly selected cases where GCA was suspected and those for negative temporal artery biopsies (TABs) were compared with the number of cross-sections per specimen for eight positive-TABs. All aforementioned examinations were conducted at our center from 2012 to 2016. Then, negative-TABs were retrieved and re-evaluated using light microscopy considering the histopathological findings of GCA.ResultsNinety-five paraffin blocks were retrieved. The original mean biopsy length was 15.39 7.56 mm. Comparison of the mean number of cross-sections per specimen for both the positive- and negative-TABs (9.25 3.37 and 9.53 2.46) showed that 9.87 2.77 [95% confidence intervals (CI)] cross-sections per specimen were sufficient for a precise GCA diagnosis. There was no statistically significant difference in the mean biopsy length (P = 0.142) among the eight positive-TABs. Similarly, no significant difference was observed in the number of cross-sections per specimen (P = 0.990) for positive-TABs compared to those for the negative-TABs. After the retrieval of negative-TABs, the mean number of total pre- and post-retrieval cross-sections per specimen was 17.66 4.43. Among all retrieved specimens, only one case (0.01%) showed the histopathological features of healed arteritis.ConclusionPositive-TABs did not reveal more histological cross-sections than the negative ones and increasing the number of cross-sections did not enhance the accuracy of TAB.
Highlights
No specific guidelines have been formulated regarding the adequate number of cross-sections needed for accurate biopsy results of temporal artery biopsies (TABs) specimens
TAB is considered as the gold standard test for diagnosing Giant cell arteritis (GCA), ambiguous findings may lead to inconclusive diagnosis or inaccurate results.[8, 9]
Characteristic histopathological findings of active GCA include pan-arteritis that is most pronounced in media, with or without multinucleated giant cells and fragmented internal elastic lamina
Summary
Giant cell arteritis (GCA) is characterized by granulomatous vasculitis of large and mediumsized vessels, and its worldwide annual. The Adequate Number of Histopathology Cross-sections of Temporal Artery Biopsy in Establishing the Diagnosis of Giant Cell Arteritis. This study was performed at a tertiary referral center to determine the appropriate number of cross-sections for a TAB examination that are required for a conclusive GCA diagnosis
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