B spectral doppler image shows dampened low resistance fl ow in right. Adventitial cystic disease of the popliteal artery is an uncommon pathology that should be considered in differential diagnostic of younger patients. Cystic adventitial disease represents an unusual cause of peripheral vascular insufficiency. The presence of adventitial inflammation in correlation with atherosclerotic lesions has been recognized for decades. The cyst arises in the outer portion of the media or subadventitial layer, most commonly in the popliteal artery.
Cystic adventitial disease of the popliteal artery. By understanding the pathogenesis of cad, we can improve the surgical treatment, reduce recurrence rates, and improve patient outcomes. Aortic pathology aortic aneurysm aortic dissection aortitis atherosclerosis cystic medionecrosis. The etiology and management of cystic adventitial disease nicholasm. Cystic adventitial disease cad is a rare vascular disorder characterized by arterial occlusion owing to the development of a cystic mass in the outer subadventitial layer. We report the case of a 26yearold male with cad of the right popliteal artery diagnosed noninvasively with 3 tesla cardiovascular magnetic resonance and confirmed on postoperative histopathology. Cystic adventitial disease cad is a rare condition that affects arteries and veins.
A comprehensive, quickreference guide to the diagnosis and management of peripheral artery disease for nonspecialists with an aging population subject to an increasing number of health risks, peripheral artery disease pad is on the rise throughout the world. Life expectancy has improved in recent years as treatment regimes have become more intensive, but current treatments are expensive, often time consuming and may affect quality of life. Cystic adventitial disease of the popliteal artery and of. T1 the etiology and management of cystic adventitial disease. We suspected adventitial cystic disease acd of the common femoral vein, and the patient underwent an operation. Cystic adventitial disease of the popliteal artery a case of spontaneous resolution. We report the case of a 62yearold female patient who presented with a onemonth history of. If you have symptoms of adventitial cystic disease, a vascular specialist can help make the diagnosis. Cystic adventitial disease cad is a rare vascular pathology which predominantly affects peripheral vessels of young otherwise healthy males. Cystic adventitial disease cyad is a rare nonatherosclerotic condition which results in intermittent claudication due to peripheral vascular insufficiency caused by compression of the arterial lumen by a cystic collection of mucinous material containing varying combination of mucopolysaccharides and mucoproteins within the adventitial layer of the artery. In the last years, several studies have investigated the relevance and impact of adventitial inflammation on atherogenesis. If you have problems viewing pdf files, download the latest version of adobe reader. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126. A multiinstitutional experience in adventitial cystic disease.
Cystic adventitial pathology as an entity in peripheral arterial disease article pdf available in the journal of cardiovascular surgery 572 october 2015 with 246 reads how we measure reads. Cystic adventitial disease cad is an uncommon vascular pathology predominantly affecting peripheral vessels. These two proteins are known to show increased expression on the intimal side of the atherosclerotic plague endothelia but not the adventitial side 43. Adventitial cystic disease of the common femoral artery. Cystic adventitial disease of the common femoral vein. Pathology outlines gross cystic disease fluid protein 15. Adventitial definition of adventitial by medical dictionary. What are the symptoms of adventitial cystic disease. Adventitial cystic disease of the popliteal artery. A color doppler image showing multilocular cystic lesion with no internal fl ow in the popliteal region causing narrowing of popliteal artery white arrow and vein dotted white arrow. The pathology of cystic fibrosis current diagnostic. Adventitial cystic disease is an unusual cause of lowerextremity ischemia.
It affects multiple organ systems and exhibits a range of clinical problems of varying severity. It affects large arteries, typically where the artery is near a joint space, and the popliteal artery is most commonly involved. The etiology remains controversial and several treatment methods have been described. Healthdayadventitial cystic disease of the common femoral vein can be mistaken for deep venous thrombosis, according to a case report published online march 8. Cystic adventitial disease cad is a rare vascular pathology which. Cystic fibrosis cf is one of the commonest lethal inherited conditions among caucasians. Cystic adventitial disease cad is a rare vascular disorder that involves the arteries and rarely the veins, most commonly found in the popliteal artery of male patients. Atkins and key first described its effect on the external iliac artery in 1947.
As pathology deals with the diseases, this subject is a must for medical students. An argument for the developmental theory nikolaos tsilimparis, md, ulrich hanack, md, sharom youse. Furthermore, the diagnosis of pe remains one of the most difficult problems confronting clinicians. Adventitial cystic disease is a rare condition in which a cyst forms in an artery and narrows or blocks blood flow. Cystic adventitial disease radiology reference article. Cystic adventitial disease cad is a rare vascular disorder that involves the arteries and rarely the veins, most. The first case of adventitial cystic disease acd was reported in 1947. Cystic adventitial disease of the popliteal artery with. In rare cases, the condition can cause cysts to form in other arteries. You will have a physical exam that includes checking the pulse in your foot and popliteal artery. All structured data from the file and property namespaces is available under the creative commons cc0 license. The nonarterial origin of cystic adventitial disease of the popliteal. Frontiers adventitial inflammation and its interaction.
Nonsurgical treatment of cystic adventitial disease of the popliteal. Within the adventitia there were several cystic spaces with a fibrous tissue wall, devoid of an epithelial lining and. Adventitial cystic disease of the popliteal artery ncbi. Adventitial cystic disease mimics deep venous thrombosis. In cystic adventitial disease, gelatinous fluid accumulates in an arterial wall cyst, and the cyst encroaches on the vessel lumen, with resulting stenosis or occlusion. It becomes more difficult to recognize preoperatively especially when the femoral vein is affected. It has been proposed recently that cystic adventitial disease, in which a cyst occurs within the popliteal artery near the knee, may occur by an articular mechanism, with a conduit leading from the joint, similar to the development of ganglion cysts, that spreads within the peroneal nerve. Cystic adventitial disease an overview sciencedirect. Cystic adventitial disease cad of the popliteal artery is a rare vascular disease of unknown etiology in which a mucincontaining cyst develops in the adventitial layer of the artery. Adventitial cystic disease acd of the common femoral vein is a rare vascular disorder. Professor, department of pathology, university of nebraska college of medicine.
Adventitial cystic disease chiihong lee,1 seyen lin,1,2 chilong chen2,3 adventitial cystic disease acd is an unusual cystic tumor of blood vessels characterized by the accumulation of mucinous substance in the adventitia of the nonaxial blood vessels ad jacent to joints. Adventitial cystic disease acd of the arteries is rare accounting for 0. A mucinous cyst in the outer media or adventitia progressively compromises the arterial lumen. Cystic adventitial disease cad is a rare vascular disorder. The condition usually affects the popliteal artery, which supplies blood to the knee joint and calf muscles and foot. Cystic adventitial disease genetic and rare diseases.
Pathology of the thoracoabdominal aorta springerlink. Cystic adventitial disease of the popliteal artery with spontaneous regression masatoshi jibiki, md, phd, atetsuro miyata, md, phd, bandhiroshi shigematsu, md, phd, tochigi and tokyo, japan abstract cystic adventitial disease cad of the popliteal artery with spontaneous regression is rare. We also excluded nine reports that were described as extraadventitial cysts or as an adventitial pathology that was not cad. Follow up this patient was operated upon and a cyst with one centimeter diameter was found in the mid popliteal artery that extended for a length of 2 cm. Two hundred and thirtyfour cases of cystic adventitial disease were collected from over two hundred world literatures and were classified into two groups. Pdf download for two cases of popliteal cystic adventitial disease.
The pathological examination confirmed the diagnosis. Cystic adventitial disease of the common femoral artery. This second edition of a very successful vascular surgery text was developed in order to address significant changes that have occurred in contemporary vascular surgery and to highlight new information that has developed regarding vascular imaging, interventional and endovascular procedures. Histopathology confirmed cystic adventitial disease as evidenced by dense fibrous adventitial tissue of the intramural cyst wall and the. Pulmonary vascular pathology forms an important challenge in daily clinical practice. Adventitial cystic disease acd of the venous system is a rare condition, but an important differential diagnosis to consider in a patient presenting with unilateral leg swelling. Adventitial cystic disease acd is a vascular condition that mainly affects the popliteal artery, presenting as a rare cause of nonatherosclerotic claudication. Timely diagnostic testing must be performed to enable. During surgical exploration, adventitial cystic mucinous disease was enucleated and the patient underwent femoral exploration, excision of the cysts and reconstruction of iliac femoral vein graft using an artificial blood vessel. Diagnosis of acd clinically is difficult, owing to a similar presentation of a deep vein thrombosis dvt and also the frequent coexistence of a dvt. It can lead to lumen occlusion and cause various symptoms and signs depending on the vessel affected. Peripheral artery disease, 2nd edition interventional.
Sonoworld provides a wide range of sonography case studies and educational materials for sonography students and professionals. N2 background cystic adventitial disease cad is a rare condition that affects arteries and veins. Cystic myxomatous adventitial degeneration of the radial artery with development of ganglion in the connective tissue. Etiologies of acd are still controversial and some hypotheses have been reported. Histology revealed a multilocular mucous filled cyst measuring approximately 15 x 8 x 7mm. It most commonly involves the popliteal artery, which typically leads to intermittent vascular claudication. Cystic adventitial disease cad is a rare cause of intermittent claudication and nonatherosclerotic conditions in middleaged men without cardiovascular risk factors.
Owen er, speechlydick em, kour nw, wilkins ra, lewis jd. Adventitial definition of adventitial by the free dictionary. Lower extremity claudication in young men can be caused by popliteal artery entrapment and vascular pathology. Adventitial cystic disease diagnosis and tests cleveland. Cystic adventitial disease of popliteal artery with venous aneurysm of popliteal vein. So if you are a medical student and wants to learn pathology you should study this book. Cystic adventitial disease cad is a rare condition in which mucinous cyst forms within the adventitia of arteries and veins. Because of pads direct links to heart attack and stroke, it is critical that internists, surgeons, cardiologists, radiologists.
Etiology of cad is uncertain and currently without a consensus agreement. The popliteal artery is most often involved, leading to symptoms of lower extremity claudication. Pathology articles covering symptoms, diagnosis, staging, treatment, prognosis, and followup. The etiology and management of cystic adventitial disease journal. Stains gross cystic disease fluid protein 15 gcdfp15. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Two cases of popliteal cystic adventitial disease treated with. Robbins basic pathology pdf is the book of human pathology or clinical pathology.
The vast majority of cases occur in arteries, with venous involvement being an extremely rare occurrence 8. Surgical treatment of cystic adventitial disease of the. Adventitial cystic disease by rayann queen on prezi. It is composed of three layers or tunicae the intima, media, and adventitia.
1298 314 1243 268 790 1319 1538 1106 1408 1006 725 327 513 1091 343 835 157 1487 1308 1338 413 979 1271 268 293 945 219 75 1047 1329 1305 864 121 959 8 1058 961 1392 800 407 1366 1399