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Microscopic Features: The normal architecture of the arterial wall is partially destroyed by a transmural lymphohistiocytic infiltrate. Multinucleated giant cells, which may contain phagocytized elastin debris, are usually present adjacent to the disrupted internal elastic lamina.

The histologic changes may be segmental and a negative biopsy does not rule out the diagnosis. According to one study, only 60% of patients with clinical presentation of temporal arteritis have a positive biopsy. The specimen should be entirely submitted and subjected to serial sectioning.

Image courtesy of: @PatholWalker

Image 10 of 17