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Washington University Experience | VASCULAR | Vasculitis - PACNS | 7A0 Case 7 History
Case 7 History ---- The patient is a 57 year old man with altered mental status and seizure activity. Operative procedure: Craniotomy. ---- The specimen consists of extensive granulomatous inflammation involving vessels of the leptomeninges with extension into the parenchyma along Virchow-Robin spaces. Numerous non-necrotizing, multinucleated giant cell-containing granulomas are identified in and around vessel walls with extensive associated chronic inflammatory infiltrates. Scattered vessels demonstrate fibrinoid necrosis of the vessel wall and vessel wall fragmentation. CD68 highlights numerous perivascular histiocytes and activated microglia. The smooth muscle actin immunostain shows focal fragmentation of vessel walls. The Fite, Acid fast Bacillus (AFB), Gomori methenamine silver (GMS) and gram stain are negative for microorganisms. The Thioflavin-S is negative for amyloid.
