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Washington University Experience | VASCULAR | Vasculitis - PACNS | 8A0 Case 8 History
Case 8 History ---- The patient is a 73 year old man who suffers from progressive dementia. An MRI showed extensive white matter changes, consistent with small vessel disease. Operative procedure: open brain biopsy. ---- Sections of the brain biopsy show non-caseating granulomatous inflammation of blood vessel and capillary walls in the leptomeninges and brain parenchyma. The granulomas are composed of epithelioid macrophages and multinucleated giant cells with surrounding lymphocytes. Some vessels have been completely destroyed by the granulomatous inflammation. Special stains highlight the granulomas and show focal destruction of the internal elastic lamina. The brain parenchyma shows diffuse, mild, reactive gliosis.
