case_images: PMC11165120_01
case_images: Preoperative imagery of infrarenal aortic aneurysm. (A) Three-dimensional computed tomography aortic aneurysm reconstruction with the TeraRecon Aquarius workstation preoperatively. (B) Preoperative computer tomography angiography of the infected abdominal aortic aneurysm with anterior aortic wall thickening and enhancement (white arrow). (C) Preoperative 18FDG-PET/CT revealing a significant uptake of anterior aneurysm wall (purple circle). bw, body weight.
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case_images: PMC11165120_01_fcvm-11-1418949-g001.jpg
case_images: F1
case_images: During the follow-up (FU), the patient described a persistence of inflammatory abdominal pain, and at the 6-month FU, CTA showed a significant progression of the aortic aneurysm (+6 mm) and an intense perianeurysmal contrast uptake indicative of ongoing inflammatory activity (Figure 1).
case_images: Surgical open repair treatment. (A) View of the complete removal of the affected aortic aneurysm segment along with the surrounding tissue. (B) Intraoperative view of aortic reconstruction using a self-made bifurcated graft with a bovine pericardial patch.
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case_images: F2
case_images: The aneurysm was completely removed, and the aortic reconstruction used a self-tailored bovine pericardial bifurcated graft (Figure 2).
case_images: Historical characteristics of the abdominal inflammatory aneurysm. (A) Severely altered aneurysmal wall with complex atherosclerotic plaques, thickened intima and surface thrombus (*), fragmented medial layer, and dense connective tissue in the adventitial layer inflammatory lesions next to atherosclerotic lesions but also far away, indicated with black arrows (Hematoxyline-Eosine-Safran, original magnification x20). (B) Severely altered aneurysmal wall with disrupted architecture with loss of elastin fibers in the medial layer ( ) (Weigert, original magnification x20). (C) Aortitis with abundant inflammatory infiltrate, especially in the adventitial layer, composed of lymphocytes and plasma cells (Hematoxyline-Eosine-Safran, original magnification x20). (D) Zoomed-in section demonstrated the lymphoplasmacytic pattern of the inflammatory infiltrate (Hematoxyline-Eosine-Safran, original magnification x400). (E) Zoomed-in section shows strong membranous and cytoplasmic straining of lymphocytes of anti-CD3 antibody (Immuno Histo Chemistry, original magnification x400).
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case_images: PMC11165120_01_fcvm-11-1418949-g003.jpg
case_images: F3
case_images: The inflammatory infiltrate consisted of CD3+ CD8+ T lymphocytes, CD138+ plasma cells, CD68+ CD163+ macrophages, and rare giant cells without well-defined granuloma (Figure 3).