Histopathology of Giant Cell (temporal) Arteritis – Changes in Aorta

Giant cell arteritis (GCA) is a systemic granulomatous vasculitis of unknown aetiology, which typically affects the branches of carotid artery (especially the temporal artery), but it can involve any medium-size or large artery, and then its diagnostics becomes much more difficult. The aim of our study is to point up typical histopathological changes in the aorta of GCA patients. In the study we discuss case reports of three patients in which the diagnosis of giant cell arteritis was established during autopsy. An 86-year-old man, who died of acute myocardial infarction, had aneurysms of the abdominal aorta and both iliac arteries. Death of an 84-year-old woman was caused by dissecting an aneurysm reaching from the ascending thoracic aorta to the abdominal aorta, ending at truncus coeliacus. The third patient, an 81-year-old man, had a dissecting aneurysm of the ascending aorta. Typical histopathological changes in the aorta of patients with GCA include granulomatous inflammation, presence of giant cells – especially in media, atrophy of smooth muscles and destruction of elastic fibres, splitting and fragmentation of the lamina elastica interna, as well as deposition of calcium salts into the area of the lamina elastica interna, diffuse inflammation of the vessel wall, and ingrowth of capillaries (neovascularisation). Giant cell arteritis involving the aorta can be a lethal disease and can be manifested in a dramatic way, by dissection or rupture of the aorta in the elderly. Early diagnostics of the disease, proper treatment, and life-long checks of patients with diagnosed GCA can prevent severe complications such as aortal aneurysm. k e y w o r d s Giant cell arteritis, Involvement of aorta, Histopathology, Aortic aneurysm