Takayasu arteritis is a granulomatous inflammation of large vessels primarily affecting young Asian women. Which layer of the aorta and its branches shows the predominant inflammatory infiltrate?

• A Media and adventitia (transmural, panarteritis with vasa vasorum inflammation) ✓
• B Intima with foam cell accumulation and fibrous plaque formation
• C Exclusively the adventitia sparing the media and intima
• D Internal elastic lamina with fibrinoid necrosis

Explanation

Takayasu arteritis shows transmural granulomatous inflammation (panarteritis) predominantly affecting the media and adventitia of the aorta and its major branches. Inflammation often starts in the adventitia and vasa vasorum ('outside-in' pattern), with CD4+ T cells, macrophages, and giant cells. This leads to intimal thickening, fibrosis, stenosis ('pulseless disease'), and occasionally aneurysm. Fibrinoid necrosis is a feature of polyarteritis nodosa.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.