Revisiting the Pathological Evaluation of the Thoracic Aortic Aneurysm

Abstract

Antonio Manenti, Luca Roncati, Giuseppe Barbolini

Objective: The most recent molecular acquisitions about the pathogenesis of the thoracic aortic aneurysm permit to better understand also the morphological counterpart of this disease, where atherosclerosis is not the only factor involved. The cascade of pathological processes leading to the development of the thoracic aortic aneurysms is multifactorial. Methods: We have investigated five surgical specimens of aneurysms of the thoracic aorta, collected from patients without Marfan's disease or other related genetic syndromes. Histochemistry for elastic fibers and mucosubstances has been performed, following the standard staining protocols. Results: The elastolysis, which can be considered a starting process, involves all the tunica media and it is followed by the mucoid degeneration characterized by the deposition of basophilic mucopolysaccaridic substance. Finally, the overlap of classic atherosclerotic lesions is observed, inside the whole aortic wall. Conclusions: The development of a thoracic aortic aneurysm is a complex event, where different factors and processes are involved, other than the well-known atherosclerosis, which can finally appear the most evident aspect of the overt disease.