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Rupture of splenic artery aneurysms (SAAs) is associated with a high mortality rate. The aim of this study was to identify the features of SAAs. Tissue sections from SAAs were compared to nonaneurysmal splenic arteries using various stains. The presence of intraluminal thrombus (ILT), vascular smooth muscle cells (VSMCs), cluster of differentiation (CD)-68+ phagocytes, myeloperoxidase+ neutrophils, CD3+, and CD20+ adaptive immune cells were studied using immunofluorescence microscopy. Analysis of SAAs revealed the presence of atherosclerotic lesions, calcifications, and ILT. Splenic artery aneurysms were characterized by a profound vascular remodeling with a dramatic loss of VSMCs, elastin degradation, adventitial fibrosis associated with enhanced apoptosis, and increased matrix metalloproteinase 9 expression. We observed an infiltration of immune cells comprising macrophages, neutrophils, T, and B cells. The T and B cells were found in the adventitial layer of SAAs, but their organization into tertiary lymphoid organs was halted. We failed to detect germinal centers even in the most organized T/B cell follicles and these lymphoid clusters lacked lymphoid stromal cells. This detailed histopathological characterization of the vascular remodeling during SAA showed that lymphoid neogenesis was incomplete, suggesting that critical mediators of their development must be missing.

Splenic artery aneurysms represent approximately 60% of visceral arterial aneurysms. Their incidence at autopsy is 0.02 - 2 % in all age groups and rises to 10.4% above the age of 60. Although splenic artery aneurysms are the most common visceral aneurysms, giant splenic artery aneurysms >10 cm in diameter have rarely been reported. A recent review of the literature came up with 12 true giant splenic artery aneurysms >10 cm. A case of 12-cm splenic artery aneurysms is presented in this study and the imaging findings are described.

Aneurysms of the proximal subclavian artery are extremely rare. A 39-year-old female with an incidental finding of a small proximal left subclavian artery aneurysm at its origin from the aortic arch is described. This was an incidental finding during workup for chest pain. No other vascular abnormalities were found and no obvious etiology was identified. The workup, plan for conservative treatment, and close follow-up are described. Although larger aneurysms and those in the middle and distal subclavian arteries, symptomatic or asymptomatic, are generally considered for surgical treatment, very little is known about the natural history of small proximal subclavian aneurysms.

Venous aneurysms are lesions that can be difficult to diagnose and may be a source of significant morbidity. Venous aneurysms have been reported to occur in most major veins, neck, central thoracic veins, and extremities. The authors report 4 cases of venous aneurysms: 1 of the upper and 3 of the lower extremity. All patients underwent aneurysmectomy with end-to-end anastomosis and no complications after surgery were reported. These cases are presented along with a review of literature and their origin, diagnosis, and treatment.

The authors report a case of bilateral pulmonary artery aneurysm in a patient with chronic Chagas' disease and compensated congestive heart failure in whom clinical clues suggested pulmonary thromboembolism, and the actual nature of the lesions was discovered at the time of conventional imaging investigations. This case shows the rarity of bilateral pulmonary aneurysm associated with bilateral pulmonary thromboembolism and the importance of an awareness of this condition in the differential diagnosis for lung masses.

Venous aneurysms are rare lesions that may be the source of pulmonary emboli and can result in death. The authors have recently treated several patients who had venous aneurysms of the upper extremity, lower extremity, and jugular system. Venous aneurysms usually appear to have a safe natural history in these locations, although all of the reported patients required surgery after the development of symptoms owing to complaints of pain, and/or cosmetic appearance, and/or a diagnosis of thrombosis. These cases are presented, along with a review of venous aneurysms occurring at other sites and their causes.

A 33-year-old man presented with a palmar aneurysm accompanied by painful ipsilateral clubbing finger in his right hand. Following resection of the aneurysm and arterial reconstruction with a cephalic vein graft, the pain in his fingers disappeared. Histologic examination identified the resected tissue as a true aneurysm. The clubbing finger was ascribed to chronic ischemia due to a stenotic lesion associated with palmar arch hypoplasia and aneurysm. The following is the first reported case of palmar aneurysm accompanied by ipsilateral clubbing finger.

A sixteen-year-old boy presented with varied symptoms to the hospital. After he had been diagnosed as having Behçet's disease, investigations revealed two carotid aneurysms in the right common carotid artery and one abdominal aortic aneurysm. The aneurysms were resected, medical therapy was started, and the patient recovered well. Although multiple aneurysms have been reported previously, the authors believe this is the first reported case involving both the carotid and the aorta.

Klippel-Trenaunay syndrome is characterized by the triad of unilateral port-wine hemangiomas, varicose veins, and hypertrophy of bone and soft tissue affecting one or more limbs. The rare F.P. Weber syndrome describes the mentioned entity and additional arteriovenous malformations. The association of an arterial aneurysm with the F.P. Weber syndrome has never been described in the current literature. A case of a brachial artery aneurysm in a patient with F.P. Weber syndrome is presented and the etiology of arterial aneurysm combined with congenital vascular abnormalities is discussed.

Six black patients with extraaortic intimomedial mucoid degeneration of the major arterial branches of the aorta are reported. Five patients presented with aneurysmal dilatation of the arterial wall as a result of the intimomedial mucoid degeneration, and the sixth patient had superimposed occlusive thrombosis. The ages ranged from twenty to fifty years. Five patients were female. Two were hypertensive. All patients in this study underwent reconstructive vascular surgery. The clinical and histopathologic findings are discussed.

A kidney transplant patient developed recurrent hypertension on two successive occasions associated with lesions of the renal artery. The first episode of hypertension was caused by renal artery stenosis and was surgically corrected; the second was caused by a sizable pseudoaneurysm at the site of arterial anastomosis which was resected, and arterial continuity was successfully re-established.

With increased use of renal angiography and ultrasonography, intrarenal aneurysms and arteriovenous malformations have been easily diagnosed. The authors report a case of small, bilateral intrarenal aneurysms with calcifications that were associated with a visible pulsatile wall motion recorded by M-mode ultrasonography. The finding of selective renal angiography was consistent with bilateral intrarenal aneurysms. Accelerated atherosclerosis and long-term history of hypertension were thought to have caused them.

A case of bilateral pulmonary artery aneurysms is presented. Serial cardiac catheterizations over an 8-year period showed remarkably little hemodynamic change. Thus there may be a long period of clinical and hemodynamic stability in this condition.

An arterial aneurysm of any kind is rare in infancy, and one that occurs in the brachial artery is probably even more rare; when such an aneurysm is asymptomatic and congenital, it must be exceedingly rare. One such unique case is described herein, together with a brief review of the literature.

Fibromuscular dysplasia (syn. arterial dysplasia, fibromuscular hyperplasia, medial fibroplasia) is an arteriopathy of unknown etiology, most frequently involving the renal arteries. The string-of-beads appearance of these lesions seems to be a characteristic angiographic finding. We report atypical angiographic findings at an unusual site, which proved to correspond to fibromuscular dysplasia at histological examination.