| An Autopsy Case of Takayasu’s Disease |
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Jae Hyuk Lee , Seung Che Cho , Jong Tae Park |
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Department of Pathology, Military General Laboratory Department of Forensic Medicine, Chonnam National University Medical School |
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| Abstract |
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A 22 year old male patient was admitted to t he Emergency room of local clinic because of the stuporous mental status. On physical examination, he appeared as a chronically ill, slender man. There was complete absence of the left aim pulse, and a prominent thrill and briuts were present over the right subclavicular area. The blood pressure which checked in the other regions except for the left arm was hypertensive (right arm 180/100, right leg 210/120, and left leg 200/l30mmHg) . An x ray film of the chest and doppler ultrasounds showed characteristic dilatation of aortic arch, ascending aorta and innominate artery. The clinical impression was Takayasu’s disease. This patient’s condition deteriorated rapidly in spite of intensive care and died on the seventh hospital day. At autopsy, the cause of death was massive left brain infarction due to middle cerebral artery embolization. The opened luminal surface of the aorta and its major branches revealed irregulary thick-walled, tree-bark-like appearance. Also in the left common carotid artery, the lumen was nearly obliterated by thromi and intimal fibrous plaques. But the thoraco-abdominal aorta was spared. Microscopic exainination disclosed granulomatous and sclerosing arteritis. In the former, the inflammatory process was confined to the media and adventitia and the cell infiltrate consisted predominantly of lympliocytes, plasma cells and histiocytes, with a varying number of giant cells. The latter was characterized bland intimal fibrous hyperplasia, medial degcneration with disrupted elastic lamella, and adventitial fibrosis. The pathologic diagnosis was Takayasu's disease of type I. |
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