Why Do Temporal Arteries Go Wrong?

Principles and Pearls From a Clinician and a Pathologist

Yara Banz; John H. Stone


Rheumatology. 2018;57(2):ii3-ii10. 

In This Article

Excessively High Expectations

The problem of excessively high expectations is summed up by a statement and its corollary, both attributed to Dr Oscar Rambo, professor emeritus at the University of California-San Francisco as follows: 'A mystic (and dangerous) assumption prevails in the mind of the clinician that the pathologist can produce a statement of absolute truth based on a small piece of tissue'.[3] The corollary to this statement is that: 'Equally dangerous to mankind is the pathologist who thinks the same.'

Many clinicians believe that temporal artery biopsy is the ultimate arbiter of whether a patient has GCA and that the diagnosis of GCA cannot be excluded without this procedure. Rambo's quotation underscores that pathologists must understand not only the value of temporal artery biopsies but also their potential shortcomings.