aortic valvulitis in Behcdet

Synopsis

 severe aortic regurgitation
 aortic cusps minimally thickened and
elongated with redundant motion
 severe prolapse
 +/- formation of conglomerated mesh-like mass or echo-free
space extending into the aortic root or interventricular
septum, mimicking periaortic abscess could be
observed

 characteristic mixed acute and chronic inflammation of various stages
coexisting in a given lesion.
 Valvular leaflets are involved either diffusely or focally.
 The endothelial lining is lost extensively with fibrin deposition.
 Newly formed vessels in the granulation tissue show similar features.
 Acute endothelialitis with mixed neutrophilic and lymphoid infiltrates is present at any stage, suggesting that endocardial/endothelial damage is critical for the
pathogenesis and the activity of disease.
 There are frequent microabscess with occasional granulomatous reaction.
 Heavy infiltrates of neutrophils and lymphoid cells are reminiscent of an infective
endocarditis. However, no organism is identified by blood culture or special staining.
 There are numerous CD68-positive histiocytes.
 The infiltrating lymphocytes mostly consisted of T cells with only scanty B cells.