Histopathologic Examination of a Temporal Artery Biopsy Following Long-Term Oral CorticosteriodTherapy

Abstract

Abstract: : Purpose: To examine the histopathologic findings in a temporal artery biopsy obtained from a case of giant cell arteritis that was found to be biopsy-positive following more than 20 years of oral corticosteriod therapy. Methods: We review the case of a 75-year-old white woman with a history of polymyalgia rheumatica. The patient had been treated with low-dose oral prednisone for 20 years but had recently presented with new onset signs and symptoms suggestive of giant cell arteritis. A temporal artery biopsy had been performed which was reported as having characteristic features compatible with a diagnosis of giant cell arteritis. Histopathologic sections of this patient's temporal artery biopsy were obtained from the archives and slides stained with hematoxylin-eosin, Masson trichrome, and Verhoeff elastic tissue were reviewed with respect to known microscopic features previously documented in cases of temporal arteritis. Results: The histopathologic findings of the temporal artery biopsy performed in our patient treated with long-term corticosteriods shows areas of healed arteritis along with other focal areas of acute and chronic inflammation. Conclusion: Temporal artery biopsy is a valuable confirmatory diagnostic tool in patients who present with the signs and symptoms of giant cell arteritis despite years of oral corticosteriod treatment.

Keywords: 486 neuro-ophthalmology: diagnosis • 507 pathology: human • 625 visual impairment: neuro-ophthalmological disease