NEW INSIGHTS INTO AORTITIS CLASSIFICATION: A MINIREVIEW

  • Doina BUTCOVAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Loredana-Beatrice UNGUREANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Dana BARAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Aortitis is a general term that refers to a broad category of infectious or noninfectious conditions in which an abnormal inflammation of the aortic wall occurs. These inflammatory conditions have different clinical and morphologic features and variable prognoses. The most common causes of noninfectious aortitis are the large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, together with several rheumatic diseases. Infectious aortitis is a rare but potentially life-threatening disorder. In this paper, we reviewed the most common etiologic types of aortitis, noting some diagnostic issues, discussing some pathological classifications suggestive of a certain etiology and outlining the role of the pathologist.

Author Biographies

Doina BUTCOVAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-Functional Sciences (I)
“Prof. Dr. George I. M. Georgescu” Cardiovascular Diseases Institute Iasi

Loredana-Beatrice UNGUREANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-Functional Sciences (I)

Dana BARAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Preventive Medicine and Interdisciplinarity

References

1. Gornik HL, Creeper MA. Aortitis. Circulation 2008; 117(23): 3039-3051.
2. Leone O, Agozzino L, Angelini A, et al. Criteria for histopathologic diagnosis of aortic disease Consensus Statement from the SIAPEC-IAP Study Group of “Cardiovascular Pathology” in collaboration with the Association for Italian Cardiovascular Pathology. Pathologica 2012; 104 (7): 9-24.
3. Burke AP, Tavora F, Narula N, Tomaszewski JE, Virmani R. Aortitis and ascending aortic aneurysm: description of 52 cases and proposal of a histologic classification. Hum Pathol 2008; 39(4): 514-526.
4. Bley TA, Ghanem NA, Foell D, et al. Computed tomography coronary angiography with 370-millisecond gantry rotation time: evaluation of the best image reconstruction interval. J Comput Assist Tomogr 2005; 29(1): 1-5.
5. Koster J M, Matteson LE, Warrington JK. Large-vessel giant cell arteritis: diagnosis, monitoring and management. Rheumatology 2018; 57(suppl.2): ii32-ii42.
6. Zehr KJ, Mathur A, Orszulak TA, Mullany CJ, Schaff HV. Surgical treatment of ascending aortic aneurysms in patients with giant cell aortitis. Ann Thorac Surg.2005; 79(5): 1512-1517.
7. Gotway MB, Araoz PA, Macedo TA, et al. Imaging findings in Takayasu's arteritis. AJR Am J Roentgenol 2005; 184(6): 1945-1950.
8. Nastri MV, Baptista LP, Baroni RH, et al. Gadolinium-enhanced three-dimensional MR angiography of Takayasu arteritis. Radiographics 2004; 24 (3): 773-786.
9. Sueyoshi E, Sakamoto I, Hayashi K. Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation. AJR Am J Roentgenol 2000; 175 (6): 1727-1733.
10. Liang KP, Chowdhary VR, Michet CJ, et al. Noninfectious ascending aortitis: a case series of 64 patients. J Rheumatol 2009; 36 (10): 2290-2297.
11. Miller DV, Isotalo PA, Weyand CM, Edwards WD, Aubry MC, Tazelaar HD. Surgical pathology of noninfectious ascending aortitis: a study of 45 cases with emphasis on an isolated variant. Am J Surg Pathol. 2006; 30(9): 1150-1158.
12. Yasemin Ozkan. Cardiac Involvement in Ankylosing Spondylitis. J Clin Med Res 2016; 8(6): 427-430.
13. Sakane T, Takeno M, Suzuki N, Inaba G. Behçet's disease. N Engl J Med 1999; 341(17): 1284-1291.
14. Kurata A, Kawakami T, Sato J, Sakamoto A, Muramatsu T, Nakabayashi K. Aortic aneurysms in systemic lupus erythematosus: a meta-analysis of 35 cases in the literature and two different pathogeneses. Cardiovasc Pathol 2011; 20(1): e1-e7.
15. Corominas H, Tsokos M, Quezado M, Tsokos GC. Aneurysm of the ascending aorta in systemic lupus erythematosus: Case report and review of the literature. Eur J Rheumatol 2017; 4(2): 133-135.
16. Mahajan VS, Mattoo H, Deshpande V, Pillai SS, Stone JH. IgG4-related disease. Annu Rev Pathol. 2014; 9: 315-347.
17. Agaimy A, Weyand M, Strecker T. Inflammatory thoracic aortic aneurysm (lymphoplasmacytic thoracic aortitis): a 13-year-experience at a German Heart Center with emphasis on possible role of IgG4. Int J Clin Exp Pathol 2013; 6(9): 1713-1722.
18. Foote EA, Postier RG, Greenfield RA, Bronze MS. Infectious Aortitis. Curr Treat Options Cardiovasc Med 2005; 7(2): 89-97.
19. Saraiva RS, César CA, Mello MA. Syphilitic aortitis: diagnosis and treatment. Case report. Rev Bras Cir Cardiovasc. 2010; 25(3): 415-418.
20. Vaideeswar P. Syphilitic aortitis: Rearing of the ugly head. Indian J Pathol Microbiol 2010: 53 (4): 624-627.
21. Delaval L, Goulenok T, Achouh P, et al. New insights on tuberculous aortitis. J Vasc Surg 2017; 66(1): 209-215.
22. Dong JS and Joon BK. Tuberculous Aortitis Complicated with Pseudoaneurysm Formation in the Descending Thoracic Aorta: A Case Report. Korean J Thorac Cardiovasc Surg 2012; 45(6): 408-411.
23. Yoshida M, Mukohara N, Honda T, Ozaki N, Shida T. Inflammatory aneurysm of the ascending aorta: report of a case. Surg Today. 2007; 37(9): 794-797.
24. Lavall D, Schäfers HJ, Böhm M, Laufs U. Aneurysms of the ascending aorta. Dtsch Arztebl Int 2012; 109(13): 227-233.
25. Vaglio A, Buzio C. Chronic periaortitis: a spectrum of diseases. Curr Opin Rheumatol 2005; 17 (1): 34-40.
26. Stone JR, Bruneval P, Angelini A, et al. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases. Cardiovasc Pathol 2015; 24(5): 267-278.
27. Unizony S, Stone JH, Stone JR. New treatment strategies in large-vessel vasculitis. Curr Opin Rheumatol 2013; 25(1): 3-9.
28. Deipolyi AR, Czaplicki CD, Oklu R. Inflammatory and infectious aortic diseases. Cardiovasc Diagn Ther 2018; 8(Suppl 1): S61-S70.
Published
2019-12-29