| Abstract: | Temporal artery biopsy is recommended for diagnosis of suspected giant cell arteritis, a systemic vasculitis of older adults. There is currently no formal consensus for histological interpretation of the biopsies. Typical histological findings include a transmural lymphocytic infiltrate with a population of macrophages resulting in destruction of the internal elastic lamina. However, it is a patchy process and multiple tissue levels must be examined. It is important to be aware of various subtle features that may lead to a diagnosis of arteritis, and immunohistochemistry can be helpful in some cases. Some biopsies show unusual features that could raise a differential diagnosis of alternative vasculitides. When there is no evidence of arteritis in a specimen, there are often non-specific features seen in the context of age-related changes. All of these histological patterns require close clinicopathological correlation to ensure correct interpretation. |
