A 62-year-old man presents with jaw claudication, scalp tenderness, and sudden visual loss in the right eye. ESR is 98 mm/hr. Which pathological finding in the temporal artery biopsy is MOST characteristic?
- A Granulomatous inflammation with giant cells around the internal elastic lamina ✓
- B Fibrinoid necrosis with neutrophilic infiltrate
- C Onion-skin intimal hyperplasia
- D Eosinophilic infiltration with granulomas
Correct answer: A. Granulomatous inflammation with giant cells around the internal elastic lamina
Explanation
Giant cell arteritis (GCA) classically shows granulomatous panarteritis with lymphocytes, macrophages, and multinucleated giant cells concentrated around a fragmented internal elastic lamina. Fibrinoid necrosis with neutrophilic infiltrate is characteristic of polyarteritis nodosa. Onion-skin hyperplasia occurs in Takayasu or hypertensive arteriopathy. Eosinophilic granulomas suggest eosinophilic granulomatosis with polyangiitis (EGPA/Churg-Strauss).
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.