Inflammatory Aneurysm of the Ascending Aorta: Report of a Case

Abstract

Inflammatory aortic aneurysms are found most commonly in the infrarenal abdominal aorta. We report the case of a 78-year-old man with an inflammatory aortic aneurysm of the ascending aorta, which is extremely unusual. Surgery revealed that the ascending aorta was adherent to the superior vena cava and pulmonary artery, but a dissection membrane was not found. The wall of the ascending aorta was up to 20 mm thick with perianeurysmal fibrosis. Pathologic examination revealed an inflammatory aneurysm with adventitia remarkably thickened by fibrotic tissue and infiltrated by lymphocytes and plasma cells. Our search of the literature found only seven other cases of an inflammatory ascending aortic aneurysm. Preoperative diagnosis was very difficult in most of these cases; however, improved scanning techniques using multidetector row computed tomography may allow the differential diagnosis of this clinical entity.

The complex interplay among atherosclerosis, inflammation, and degeneration in ascending thoracic aortic aneurysms

“…The pathogenetic role of inflammation in aortic aneurysms has been addressed mainly in the context of abdominal aneurysms, [12][13][14][15][16][17] whereas the implications of inflammatory substrates for thoracic aortic remodeling have yet to be fully established. 12,18,19 Medial inflammatory response to atherosclerosis is known to correlate with a negative histological remodeling of the aortic media. 20 Aortic coarctation, n (%) 3 (1.7) 0 (0) 0 (0) .481…”

A clinicopathologic study of immunoglobulin G4-related sclerosing disease of the thoracic aorta

“…[10][11][12] Thus, "inflammatory TAA" is considered to be a vague and rarely reported entity, in contrast with inflammatory AAA. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Indeed, patient 1(0.8%), with inflammatory TAA with thicker adventitia (Ͼ5 mm), met our criteria for IgG4-SD. IgG4-related inflammatory TAA has also been reported more recently, 21 and that case was consistent with our findings for IgG4-TAA.…”

Aneurismas de aorta inflamatorios y su relación con la patología urológica: caso clínico y revisión de la literatura científica

“…Figura 1 -Riñones y sistemas excretores dentro de la normalidad. extremadamente infrecuentes en la aorta ascendente 4 . Dos características prácticamente patognomónicas son el aspecto macroscópico y la anatomía patológica.…”