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aortic valvulitis in Behcdet

Thursday 19 September 2013

Synopsis

- severe aortic regurgitation
- aortic cusps minimally thickened and
elongated with redundant motion
- severe prolapse
- +/- formation of conglomerated mesh-like mass or echo-free
space extending into the aortic root or interventricular
septum, mimicking periaortic abscess could be
observed

- characteristic mixed acute and chronic inflammation of various stages
coexisting in a given lesion.
- Valvular leaflets are involved either diffusely or focally.
- The endothelial lining is lost extensively with fibrin deposition.
- Newly formed vessels in the granulation tissue show similar features.
- Acute endothelialitis with mixed neutrophilic and lymphoid infiltrates is present at any stage, suggesting that endocardial/endothelial damage is critical for the
pathogenesis and the activity of disease.
- There are frequent microabscess with occasional granulomatous reaction.
- Heavy infiltrates of neutrophils and lymphoid cells are reminiscent of an infective
endocarditis. However, no organism is identified by blood culture or special staining.
- There are numerous CD68-positive histiocytes.
- The infiltrating lymphocytes mostly consisted of T cells with only scanty B cells.