Lymphoplasmacytic aortitis and acute aortic dissection. An uncommon association.
A 43-year-old white man with a history of cigarette smoking, hypertension, nephrolithiasis, and cervical degenerative arthritis was hospitalized for sudden-onset severe, substernal, and pleuritic chest pain with epigastric radiation. Despite evaluation, the cause remained unclear and the patient expired on hospital day 5. Autopsy revealed acute Stanford type A aortic dissection, hemopericardium, and hemothorax. Grossly, the aorta and its branches, including uninvolved medium-sized arteries, displayed extreme mural fragility. Microscopic examination showed a primary lymphoplasmacytic aortitis-periaortitis without giant cells. Rents within the tunica media, medial-adventitial inflammation, and elastic fiber disruption were limited to sites of gross aortic dissection. Muscular arteries showed patchy, chronic arteritis-periarteritis without giant cell infiltrate or aneurysm formation. This case documents an unusual association of primary lymphoplasmacytic aortitis and aortic dissection.
Faye-Petersen
O M
OM
Department of Pathology, University of Alabama at Birmingham, 35233-1924, USA.
Arnold
M M
MM
Grizzle
W E
WE
Lie
J T
JT
D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000473:pathology; D001014:Aortic Aneurysm / Q000150:complications* / Q000473:pathology; D001025:Aortitis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D010950:Plasma Cells / Q000473:pathology