Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
Objective: To identify morphological features of aortic wall structure in various pathologies that could serve as differential diagnostic criteria. Methods: The study was conducted at the Pathology Department of the Republican Research Center for Emergency Medicine (Tashkent, Uzbekistan) from Jan...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Center for Scientific Research and Development of Education.
2025-07-01
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| Series: | Heart Vessels and Transplantation |
| Subjects: | |
| Online Access: | http://hvt-journal.com/articles/art578 |
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| Summary: | Objective: To identify morphological features of aortic wall structure in various pathologies that could serve as differential diagnostic criteria.
Methods: The study was conducted at the Pathology Department of the Republican Research Center for Emergency Medicine (Tashkent, Uzbekistan) from January 2024 to May 2025. Thirteen biological samples were obtained from patients with aortic pathologies: aneurysms combined with atherosclerotic lesions (n=5), Marfan syndrome (n=5), rupture of the sinus of Valsalva (n=2), and Takayasu syndrome (n=1). This unique cohort represents the first comparative study of these four pathologies using standardized quantitative morphometry in an emergency surgical setting. Histological preparations were examined using a ZEISS Axiostar Plus fluorescence microscope. Quantitative analysis was performed using Fiji by ImageJ software. Statistical analysis was conducted using SPSS 23.0 with the Kruskal-Wallis test and Mann-Whitney post-hoc comparisons.
Results: In Marfan syndrome, focal destruction of elastic lamellae in the tunica media, cystic medial degeneration, and uneven accumulation of glycosaminoglycans were identified. In sinus of Valsalva aneurysms, uneven thickness of collagen and reticulin fibers with pronounced edema of the middle layer were observed. Takayasu syndrome demonstrated inflammatory infiltration of the middle layer and a marked decrease in smooth muscle fibers. Patients with atherosclerosis showed severe calcification of the middle layer and presence of cholesterol crystals.
Conclusion: Morphological examination of the aortic wall in various pathologies revealed significant differences in structure and composition of wall components, confirming the heterogeneity of aortic aneurysm pathogenesis. This study establishes the first quantitative morphometric thresholds for differential diagnosis: elastic fiber density <20% indicates Marfan syndrome, inflammatory cell count >250 cells/mm² suggests Takayasu arteritis, and calcification >40% of medial area characterizes atherosclerotic aneurysms. These findings provide a foundation for developing differentiated therapeutic approaches and rapid diagnostic protocols in emergency surgical settings. |
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| ISSN: | 1694-7886 1694-7894 |