Which histologic findings are characteristic of vasculitis?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
  • Print
Answer

See the list below:

  • Takayasu arteritis: Inflammatory infiltrate is composed of T cells. Macrophages are arranged into granulomas with giant cells. Concentric thickening of all layers of the artery wall (intima, media and adventitia) is noted.

  • Polyarteritis nodosa: Acute and segmental necrotizing vasculitis of medium-sized arteries is seen with an inflammatory infiltrate composed of neutrophils and eosinophils within the vessel walls and extravasation of erythrocytes and fibrin.

  • Churg-Strauss syndrome: In the lung, extravascular microgranulomas filled with eosinophils and intramural eosinophilic infiltrate are noted.

  • Granulomatosis with polyangiitis (GPA) (formerly Wegener granulomatosis): In the lung, granulomatous inflammation with mononuclear infiltrate including T cells, macrophages/histiocytes, and giant cells are noted.

  • GPA and microscopic polyangiitis: Renal histologic findings include "pauci-immune" (ie, little immune deposition on immunofluorescence) necrotizing glomerulonephritis with large circumferential crescents, segmental loss of basement membrane, and tubulointerstitial inflammation.

  • Henoch-Schönlein purpura: Immunofluorescence demonstrates deposition of IgA, C3, and fibrin in the walls of affected blood vessels within the dermis and the endothelial and mesangial cells of the kidney. Skin biopsy reveals features of leukocytoclastic vasculitis with infiltrate of neutrophils and mononuclear cells.

  • Childhood PACNS: Segmental nongranulomatous intramural infiltration of predominantly T lymphocytes involves small arteries, arterioles, capillaries, and/or venules. Surrounding reactive changes may include gliosis, calcification, and pallor of myelin staining.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!