Skip areas in temporal arteritis

Abstract

Segments of temporal arteries removed from patients with the characteristic systemic findings of temporal arteritis were studied to determine whether they showed "skip areas" lacking evidence of granulomatous inflammation, as has been frequently described in this disease, or showed diagnostic evidence of inflammation throughout the entire length of the artery. Eleven temporal artery specimens from ten patients were included in this study. Sections from areas of each specimen had previously been found to contain typical granulomatous inflammation. Nine of these biopsy specimens contained granulomatous inflammation throughout their entire length. Two specimens each had two discrete areas of granulomatous inflammation adjoining segments that lacked evidence of epithelioid or giant cells. These "skip areas" showed diffuse round-cell infiltration of the adventia or lacked evidence of inflammation entirely. This series suggests that "skip areas" in temporal arteritis do occur.