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Cystic adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance.

Tomasian A, Lai C, Finn JP, Gelabert H, Krishnam MS - J Cardiovasc Magn Reson (2008)

Bottom Line: Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery.We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

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Affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. mkrishnam@mednet.ucla.edu

ABSTRACT
Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery. We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

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(a) The cyst wall is comprised of dense, fibrous tissue, which is consistent with the adventitia of a blood vessel (H&E stain; 40×, original magnification). (b) At higher magnification (H&E stain; 100×, original magnification), foci of hemorrhage is seen within the cyst wall (arrows). (c) There were also focal areas of chronic inflammation within the cyst wall (circled areas) [H&E stain; 100×, original magnification]. (d) The cyst contents consist mostly of proteinaceous debris with rare, scattered degenerated macrophages (arrow) [H&E stain; 400×, original magnification].
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Figure 4: (a) The cyst wall is comprised of dense, fibrous tissue, which is consistent with the adventitia of a blood vessel (H&E stain; 40×, original magnification). (b) At higher magnification (H&E stain; 100×, original magnification), foci of hemorrhage is seen within the cyst wall (arrows). (c) There were also focal areas of chronic inflammation within the cyst wall (circled areas) [H&E stain; 100×, original magnification]. (d) The cyst contents consist mostly of proteinaceous debris with rare, scattered degenerated macrophages (arrow) [H&E stain; 400×, original magnification].

Mentions: The patient underwent open resectional cystotomy two weeks later. The popliteal artery was exposed from a posterior approach through a longitudinal incision. A 4-cm length of the artery was observed to be grossly enlarged. The cyst was punctured and after evacuating the clear gelatinous fluid, the wall was resected with Potts scissors. With release of the cyst compression, arterial pulse distal to the lesion improved immediately. Histopathology confirmed cystic adventitial disease as evidenced by dense fibrous adventitial tissue of the intramural cyst wall and the mucoproteinaceous contents (Figure 4).


Cystic adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance.

Tomasian A, Lai C, Finn JP, Gelabert H, Krishnam MS - J Cardiovasc Magn Reson (2008)

(a) The cyst wall is comprised of dense, fibrous tissue, which is consistent with the adventitia of a blood vessel (H&E stain; 40×, original magnification). (b) At higher magnification (H&E stain; 100×, original magnification), foci of hemorrhage is seen within the cyst wall (arrows). (c) There were also focal areas of chronic inflammation within the cyst wall (circled areas) [H&E stain; 100×, original magnification]. (d) The cyst contents consist mostly of proteinaceous debris with rare, scattered degenerated macrophages (arrow) [H&E stain; 400×, original magnification].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2538522&req=5

Figure 4: (a) The cyst wall is comprised of dense, fibrous tissue, which is consistent with the adventitia of a blood vessel (H&E stain; 40×, original magnification). (b) At higher magnification (H&E stain; 100×, original magnification), foci of hemorrhage is seen within the cyst wall (arrows). (c) There were also focal areas of chronic inflammation within the cyst wall (circled areas) [H&E stain; 100×, original magnification]. (d) The cyst contents consist mostly of proteinaceous debris with rare, scattered degenerated macrophages (arrow) [H&E stain; 400×, original magnification].
Mentions: The patient underwent open resectional cystotomy two weeks later. The popliteal artery was exposed from a posterior approach through a longitudinal incision. A 4-cm length of the artery was observed to be grossly enlarged. The cyst was punctured and after evacuating the clear gelatinous fluid, the wall was resected with Potts scissors. With release of the cyst compression, arterial pulse distal to the lesion improved immediately. Histopathology confirmed cystic adventitial disease as evidenced by dense fibrous adventitial tissue of the intramural cyst wall and the mucoproteinaceous contents (Figure 4).

Bottom Line: Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery.We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. mkrishnam@mednet.ucla.edu

ABSTRACT
Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery. We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

Show MeSH
Related in: MedlinePlus