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Giant Cell Arteritis : Differential Diagnosis

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Differential Diagnosis of Giant Cell Arteritis (GCA): The main differential diagnostic considerations are changes caused by prior trauma and Takayasu arteritis.

Prior trauma: The vessel may show disruption of internal elastic lamina, medial fibrosis and aneurysmal changes; however, inflammatory component is absent. History of trauma may be available.

Takayasu arteritis (TA): Patients are much younger than those affected by GCA and the involved vessels are different (aorta and its main branches). TA shows acute inflammation with dirty necrosis.

Monckeberg Medial Calcific Sclerosis: This is common in elderly patients. Giant cells may be seen in this context; however, transmural inflammation is not present.

The image shows intimal hyperplasia, lymphohistiocytic infiltrate, multinucleated giant cells and disruption of internal elastic lamina in a case of GCA. Image copyright: pathorama.ch

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