ABSTRACT
Spontaneous (idiopathic) thoracic aortic rupture (STAR) is uncommon and assumes a rupture of the normal-sized thoracic aorta with no visually apparent aortic disease. Since 1961 about fifty reports have been published. STAR is established in cases of thoracic normal-sized aorta rupture with no traumas, aneurysms/dissections, infection, inflammation, connective tissue diseases, aortic and adjacent organs tumors/metastases, previous surgery, and occurring during pregnancy and the peripartum. Atherosclerosis penetrated atherosclerotic ulcer, neurofibromatosis type I, peri- and postpartum estrogen-mediated elastin irregularities of the aortic media, and cystic medial necrosis (CMN) were identified as a cause of STAR when histopathological examinations were performed. A case of a 68-year-old man with giant STAR of the descending aorta in the background of CMN is reported here. The patient in terminal hemodynamic condition was successfully treated by delayed open surgery two weeks after the disease's onset.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Rupture , Atherosclerosis , Male , Pregnancy , Female , Humans , Aged , Rupture, Spontaneous/surgery , Rupture, Spontaneous/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Atherosclerosis/complications , Aortic Rupture/diagnostic imaging , Aortic Rupture/etiology , Aortic Rupture/surgery , Necrosis/surgery , Necrosis/complicationsABSTRACT
Accumulations of pathological amyloid protein in the vitreous can be a pathognomonic morphological sign of systemic amyloidosis, which is characterized by deposition of insoluble fibrillar protein aggregates (amyloid) in various organs and tissues. The article describes a clinical case of a female 65-year-old patient with bilateral vitreous floaters and histologically confirmed vitreous amyloidosis on the right eye. The patient had undergone YAG laser vitreolysis of the right eye 3 years ago on the Ultra Q Reflex system («Ellex¼, Australia) to treat an atypical Weiss ring. Diagnosis of vitreous amyloidosis was confirmed using the following equipment: video slit lamp SL9900 («CSO¼, Italy), optical coherence tomography system Solix («Optovue¼, USA), B-scan Plus («Accutome¼, USA), microscope CX41RF («Olympus Corporation¼, Japan). Due to significant visual deterioration in the right eye, the patient underwent vitrectomy. Microscopic examination of the surgical sample showed the presence of amyloid deposits revealed by the brick-red specific staining with congo red dye and apple-green birefringence of the stained areas in polarized light.