) Large AGE >50 SEX Male SITE - Temporal arteries - Cranial arteries - Aortic arch PRESENTATION & MORPHOLOGY - Artery is cord- like and nodular - Thrombus in lumen - Granulomatous inflamm. of arterial wall SYMPTOMS - blurring of vision - double vision - blindness - temporal headaches
15-40
Female
- pulseless disease (due to narrowing of aortic arch) - ocular disturbances - hypertension - various neurologic defects
A. Narrowing of brachiocephalic, Carotid and subclavian artery B. Gross- intimal thickening with Minimal residual lumen
C. Histology- destruction of arterial Media by mononuclear inflamm. With giant cells Polyarteritis Nodosa Medium Young - Medium and Smaller muscular Arteries - Renal and visceral Vessels (coronary, Hepatic, mesenteric) Sparing the pulmonary - Patchy involvement of arteries Predilection for branching points - Absent small vessel involvement, No glomerulonephritis - Association with Hepatitis B - FUO - Weight loss - Hypertension - Abdominal pain & melaena - Peripheral neuritis
Extensive infiltrate to be composed of polymorphonuclear leukocytes. The vascular involvement is fully circumferential.
Segmental fibrinoid necrosis and thrombotic occlusion of the lumen of this small artery Kawasaki Disease (Muco-cutaneous LN syndrome) Medium Infancy & childhood - Necrotizing vasculitis resembling PAN (polyarthritis nodosa) - Fever - Skin rash - Conjunctival - Oral lesions - Enlarged cervical lymph nodes - When develop in CV sequelae Coronary artery aneurysms
Microscopic polyangitiis
Small
- Arterioles - Capillaries - Venules Elderly Male - Nasal sinuses - Nasopharynx - Lungs (focal necrotizing Vaculitis + acute Necrotizing granuloma) - Kidneys
- Cutaneous lesions Leukocytoclastic vasculitis - Systemoc lesions Microscopic polyarteritis - Persistent sinusitis - Pneumonitis - Hematuria - Proteinuria - Renal failure - Skin rash - Muscle pain - Articular environment - Polyneuritis - Fever
Wegeners Granulomatosis
Small
spindle shaped macrophages to form a characteristic palisading granuloma Thrombo-Angitis Obliterans / Buergers Disease Small <35 Male - Small arteries and (smoker) veins Of extremities - Neutrophil inflammation of all Coats of vessel wall together with Occlusive thrombosis. - Small microabscesses within Thrombus - Organisation & recanalization of thrombus - Superficial nodular phlebitis - Raynauds phenomena - Intermittent claudication - Ultimately gangrene of extremities