ARTERIOMEGALY AND INFLAMMATORY ABDOMINAL AORTIC-ANEURYSM - CASE-REPORT

In this case report inflammatory abdominal aortic aneurysm (IAAA) was superimposed on an arteriomegaly condition complicated by bilateral an eurysm of the common iliac arteries. Obstruction of the right meter mi ld hydronephrosis of the left system and a slight impairment of renal function were also present. Preoperative cellular and humoral immunolo gical parameters were within normal limits while the erythrocyte sedim entation rate (ESR) was elevated (74 mm). Histological analysis showed numerous scattered lymphoid cells or organized in follicles with germ inal centers within the adventitial thickening of the IAAA wall. Immun ohistochemical analysis on frozen sections demonstrated that dispersed and perivascular lymphoid cells were mainly composed of similar amoun ts of CD3+/CD4+ and CD3+/CD8+ T lymphocytes. Histological analysis of the common iliac artery aneurysm showed a mild intimal thickening will small aggregates of macrophages. After aneurysm repair all peripheral blood analysis normalized within one month after surgery. The IAAA ob served in our patient with arteriomegaly as underlying arterial diseas e cannot be interpreted as an inflammatory variation of an atheroscler otic aneurysm, The histological pattern of the inflammatory reaction a nd its resolution after surgery give, in our opinion, more credit to t he etiopathogenetic hypothesis of a reaction elicited by an antigen wi thin the arterial wall of the infrarenal aorta which might be enhanced by the lymphatic stasis subsequent to aneurysm compression.