Takayasu arteritis is a granulomatous large-vessel vasculitis predominantly affecting the aorta and its primary branches in young women. The histological finding in the arterial wall during active disease is:

• A Fibrinoid necrosis with neutrophilic infiltrate in small arterioles
• B Subintimal fibrosis with 'onion-skin' concentric layers
• C Eosinophilic vasculitis with granuloma formation in small vessels
• D Necrotizing granulomas with giant cells in the media, transmural inflammation ✓

Explanation

Takayasu arteritis shows granulomatous inflammation of the aortic wall with Langerhans-type multinucleated giant cells, macrophages, lymphocytes, and plasma cells predominantly in the media and adventitia, along with medial necrosis and subsequent fibrotic thickening causing 'pulseless disease.' Fibrinoid necrosis of small arterioles is seen in hypertensive emergency and polyarteritis nodosa; 'onion-skin' concentric fibrosis is the end-stage of malignant hypertension; eosinophilic vasculitis is seen in EGPA (Churg-Strauss syndrome).

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.