GCA Biopsy Histology — SCE Rheumatology MCQ

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HardVasculitisGCA Biopsy HistologySCE Rheumatology

Temporal-artery biopsy shows transmural granulomatous inflammation, multinucleated giant cells, internal elastic-lamina disruption and intimal hyperplasia. Which diagnosis is supported?

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Correct answer: D — Giant cell arteritis

This is the characteristic histological pattern of GCA, although giant cells are not required in every positive biopsy. Histology is interpreted with clinical probability and vascular imaging, and a negative biopsy does not automatically exclude disease.

Reference: BSR guideline on diagnosis and treatment of giant cell arteritis (Published January 2020; revision in development): https://academic.oup.com/rheumatology/article/59/3/e1/5714024; EULAR imaging recommendations in large-vessel vasculitis — 2023 update (Published 2024): https://ard.bmj.com/content/83/6/741