Takayasu aortitis with acute dissection and hemopericardium.
We report a case of a 57-year-old woman with an unremarkable past medical history who presented to the emergency department with maxillary pain that later radiated to the chest. She died less than 12 h after admission. CT findings were consistent with ascending aorta dissection with hemopericardium. Autopsy revealed a tear immediately proximal to the ostium of the brachiocephalic artery and a dissecting flap with false lumen, rupture, and hemopericardium. Histologically, there was a zonal medial necrosis with surrounding chronic inflammation, focal destruction of the media, and fibrosis of the intima and adventitia. A diagnosis of granulomatous necrotizing aortitis of Takayasu type was made. This case demonstrates a rare example of aortitis underlying aortic dissection and emphasizes the need for careful histologic examination in cases of aortic root disease.
Tavora
Fabio
F
Department of Pathology, University of Maryland, 22 South Greene Street, Room NBW43, Baltimore, MD 21201, USA. ftavo001@umaryland.edu
Jeudy
Jean
J
Gocke
Christopher
C
Burke
Allen
A
D000784:Aortic Dissection / Q000209:etiology* / Q000473:pathology*; D001014:Aortic Aneurysm / Q000209:etiology* / Q000473:pathology*; D001025:Aortitis / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D013625:Takayasu Arteritis / Q000150:complications* / Q000473:pathology*; D014057:Tomography, X-Ray Computed