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Aktuelle Rheumatologie 2014; 39(04): 267-269
DOI: 10.1055/s-0034-1374627
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Histologische Sicherung der Arteriitis temporalis (AT) mittels Biopsie: Indikation, Durchführung, Interpretation

Confirmation of Temporal Arteritis by Arterial Biopsy: Indication, Procedure and Interpretation of Histological Findings
G. Keyßer
1   Abteilung für Innere Medizin, Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Halle, Halle (Saale)
,
F. Lupatsch
2   Institut für Pathologie, Universitätsklinikum Halle, Halle (Saale)
› Author Affiliations
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Publication History

Publication Date:
15 August 2014 (online)

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Zusammenfassung

Die histologische Untersuchung der Arteria temporalis hat durch den Fortschritt bei den bildgebenden Verfahren etwas an Bedeutung verloren, gehört jedoch nach wie vor zum diagnostischen Repertoire bei Arteriitis temporalis (AT). Die typischen histologischen Veränderungen bei AT bestehen in einer granulomatösen Entzündung aller Wandschichten, in der sich mehrkernige Riesenzellen finden. Das Gefäßlumen kann durch Intimaproliferation und subintimale fibromuskuläre Hyperplasie eingeengt oder ganz verschlossen sein. Außerdem lässt sich im klassischen Fall eine Fragmentierung der Lamina elastica interna nachweisen. Neuere Arbeiten demonstrieren eine Vaskulitis der vasa vasorum, oder eine Vaskulitis kleiner Gefäße der Adventitia als histologische Untergruppen der AT.

Abstract

Although the histological examination of the temporal artery has lost some importance due to the progress in imaging techniques, the method still belongs to the diagnostic repertoire in cases of suspected temporal arteritis. Histological changes typical for temporal arteritis are granulomatous infiltrates that affect all layers of the vessel wall and contain multinucleated giant cells. The lumen of the vessel can be occluded or narrowed by proliferating cells of the intima and by subintimal fibromuscular hyperplasia. Classical findings also include the fragmentation of the internal lamina elastica. Recent investigations have identified 2 histological subgroups, dominated by either a vasculitis of the vasa vasorum or a vasculitis of small vessels of the adventitia of the temporal artery.

Schlüsselwörter

Arteriitis temporalis - Biopsie - histologische Untersuchung - Riesenzellen

Key words

temporal arteritis - biopsy - histological examination - multinucleated giant cells
 

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