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: Bokhodir A. Magrupov, Abdusalom A. Abdurakhmanov, Khamidulla A. Abdumajidov, Odilbek S. Sultanov
Format: Article
Language:English
Published: Center for Scientific Research and Development of Education. 2025-07-01
Series:Heart Vessels and Transplantation
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Online Access:http://hvt-journal.com/articles/art578
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author Bokhodir A. Magrupov
Abdusalom A. Abdurakhmanov
Khamidulla A. Abdumajidov
Odilbek S. Sultanov
author_facet Bokhodir A. Magrupov
Abdusalom A. Abdurakhmanov
Khamidulla A. Abdumajidov
Odilbek S. Sultanov
author_sort Bokhodir A. Magrupov
collection DOAJ
description 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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spelling doaj-art-7d542044a29e46cc8f9b587ffbecff392025-08-20T03:55:53ZengCenter for Scientific Research and Development of Education.Heart Vessels and Transplantation1694-78861694-78942025-07-019210.24969/hvt.2025.57Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological formsBokhodir A. Magrupov0https://orcid.org/0000-0002-8795-0724Abdusalom A. Abdurakhmanov1https://orcid.org/0000-0003-0813-9333Khamidulla A. Abdumajidov 2https://orcid.org/0000-0001-5077-7174Odilbek S. Sultanov3https://orcid.org/0009-0005-7137-0185Center for Development of Professional Qualifications of Medical Workers, Tashkent, Uzbekistan, Republican Research Center of Emergency Medicine, Tashkent, UzbekistRepublican Research Center of Emergency Medicine, Tashkent, UzbekistanBukhara State Medical Institute named after Abu Ali ibn Sina, Bukhara, UzbekistanRepublican Research Center of Emergency Medicine, Tashkent, UzbekistanObjective: 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.http://hvt-journal.com/articles/art578aortaaortic aneurysmmarfan syndrometakayasu syndromeconnective tissuemedial degenerationpathomorphology
spellingShingle Bokhodir A. Magrupov
Abdusalom A. Abdurakhmanov
Khamidulla A. Abdumajidov
Odilbek S. Sultanov
Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
Heart Vessels and Transplantation
aorta
aortic aneurysm
marfan syndrome
takayasu syndrome
connective tissue
medial degeneration
pathomorphology
title Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
title_full Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
title_fullStr Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
title_full_unstemmed Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
title_short Differential diagnosis of aortic aneurysms: pathomorphological criteria of various etiological forms
title_sort differential diagnosis of aortic aneurysms pathomorphological criteria of various etiological forms
topic aorta
aortic aneurysm
marfan syndrome
takayasu syndrome
connective tissue
medial degeneration
pathomorphology
url http://hvt-journal.com/articles/art578
work_keys_str_mv AT bokhodiramagrupov differentialdiagnosisofaorticaneurysmspathomorphologicalcriteriaofvariousetiologicalforms
AT abdusalomaabdurakhmanov differentialdiagnosisofaorticaneurysmspathomorphologicalcriteriaofvariousetiologicalforms
AT khamidullaaabdumajidov differentialdiagnosisofaorticaneurysmspathomorphologicalcriteriaofvariousetiologicalforms
AT odilbekssultanov differentialdiagnosisofaorticaneurysmspathomorphologicalcriteriaofvariousetiologicalforms