Vasculitis

Question 1

Answer 1

Aspergillus Infection of a blood vessel

Question 2

Answer 2

aspergillus infection seen with special IHC stain

Question 3

What is the arrow pointing to?

Answer 3

Blood vessel with surrounding inflammation seen in vasculitis

Question 4

Answer 4

Pseudoallescheria boydii (fungal) vasculitis

Question 5

Answer 5

Mucor (Zygomyces) vasculitis; aorta (left); with fungal forms seen in silver stain (top R)

Question 6

Answer 6

tertiary syphilitic vasculitis; inflammation within the vasa vasorum, more severe form in R image

Question 7

Answer 7

non-infectious vasculitis

Question 8

Answer 8

Temporal (Giant Cell) arteritis; a large vessel vasculitis; yellow arrow show giant cells; the larger image shows transmural acute & chronic inflammation within temporal artery

Question 9

Answer 9

Takayasu’s arteritis; affects the aorta (or major branches) in young women and children

Question 10

Answer 10

Takayasu’s arteritis; see fibrous scar and giant cells within aorta (or major branches)

Question 11

Answer 11

Polyarteritis Nodosa (PAN); a medium vessel vasculitis characterized by necrotizing inflammation of vessel wall; see pink, gooey, fibrin around a leaky vessel wall; NOT seen in glomeruli, capillaries, or small vessels; not ANCA associated

Question 12

Answer 12

PAN affecting the bowel; see degeneration of medium-sized vessel wall (yellow arrow), and lack of mucosa (green arrow) indicated ischemic colon; blue arrow just pointing to a blood clot within the vessel.

Question 13

Answer 13

Kawasaki Dz; manifests a medium-sized vessel vasculitis with propensity for coronary artery involvement; image shows two aneurysms seen on coronary angiogram

Question 14

Answer 14

ANCA seen in IF; c-ANCA (cytoplasmic; PR3) on Left; p-ANCA (perinuclear; MPO) on Right; ANCA is associated with small vessel vasculitides such as in Granulomatosis with polyangiitis, microscopic polyangiits, Churg-Strauss syndrome.

Question 15

Answer 15

Microscopic polyangiitis, a small vessel, necrotizing vasculitis with crescents; see pulmonary involvement (alveolar hemorrhage/hemoptysis)

Question 16

Answer 16

microscopic polyangiitis; see crescentic GN and necrosis; affects small vessel including glomeruli as seen in this photo

Question 17

Answer 17

sinus granulomas, seen in granulomatosis with polyangiitis (Wegener’s); a necrotizing vasculitis that affects small vessel including glomeruli, also see respiratory tract granulomas; note Giant cell in image on Right

Question 18

Answer 18

Eosinophilic granulomatosis with polyangiitis (EPGA, aka Churg-Strauss); see lots of eosinophil-rich and granulomas involving respiratory tract

Question 19

Answer 19

IgA vasculitis; aka Henoch-Schonlein Purpura; a small vessel vaculitis with IgA-predominant immune complexes; seen as mesangial IgA deposition on IF (left) and leukocytoclastic vasculitis (fragmented neutrophils) on the right.

Question 20

Answer 20

cryoglobulinemic vasculitis; abnml Ig’s that precipitate in the cold; seen as deposits in vessels of skin as well as glomeruli

Question 21

Answer 21

cutaneous leukocytoclastic vasculitis; seen clinically as palpable purpura of the skin; often drug-induced, hypersensitivity rxn, immune-complex mediated, ANCA-associated

Question 22

Answer 22

B) see fibrosis around the blood vessel