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Clinicopathologic Reports, Case Reports, and Small Case Series
August 2001

Shrinkage: Fact or Fiction?

Arch Ophthalmol. 2001;119(8):1217. doi:

The diagnosis of giant cell arteritis (GCA) is confirmed by finding characteristic histological changes in the disease in an arterial segment, such as the superficial temporal artery. The length of the arterial specimen is crucial because of the presence of "skip lesions"1 (areas of no inflammation) in GCA. Recently, there has been discussion concerning the required length of an arterial specimen to securely confirm or exclude the diagnosis of GCA.2,3 It is generally accepted that 20 mm is an adequate specimen length for a unilateral biopsy. In a "Letter to the Editor" in the Journal of the American Medical Association, the issue has been raised as to whether this is a prefixation or postfixation measurement guideline and whether formalin fixation reduces the effective length of a temporal artery biopsy specimen.4 This is a potentially important question since the accuracy of the histological diagnosis of GCA is believed to be strongly correlated to the length of the fixed artery specimen that is available for pathological assessment. We report the first available data that directly address this question.