Periarteritis nodosa is marked by circumscribed inflammation of medium-sized arteries usually in the form of greyish-white nodules up to the size of a pea, occasionally as more diffuse thickenings. The foci are scattered along the course of the vessels and at the giving off of small branches. The cerebral arteries are rarely involved, the most favorite location being the pulmonary, mesenteric, coronary, renal, hepatic and muscular arteries. As many as sixty-three nodules have been seen in one case. In Kussmaul's original case there were subcutaneous nodules over the chest and abdomen. Among the various views as to the cause of these changes, Schrotter1 advocates the one held by Eppinger, namely, that the nodules are multiple aneurysms due to a congenital defect or weakness in the elastic layer, followed by cell accumulations in the adventitia and the media. The disease seems to be a distinct entity; at times the first
PERIARTERITIS NODOSA AND SUPRA-ARTERIAL EPICARDIAL FIBROID NODULES. JAMA. 1899;XXXIII(24):1500. doi:10.1001/jama.1899.02450760056015
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