If you are asked to examine a slide containing blood vessel, the vessel is most likely to be a piece of biopsed temporal artery.  Therefore, the diagnosis is most likely to be giant cell arteritis (temporal arteritis).

In the slide look for:

• inflammatory cells in the media and intima
• presence of giant cells (not necessary for diagnosis)
• fragmented internal elastic lamina

Low magnification. H & E staining of a medium-sized artery with giant cell arteritis.  Note thickening of the media and intima with inflammatory cells  ( appearing as blue dots) ( Click here to compare it with a normal vessel ).
High magnification H & E staining showing the presence of  inflammatory and giant cells. (click here to find out if you have correctly identified the giant cells).

Common questions in the viva:

• What are the ocular symptoms of giant cell arteritis?
• What signs are suggestive of giant cell arteritis?
• What laboratory investigations would you perform (ESR vs C-reactive protein)?
• The treatment of giant cell arteritis.
• Histological features of giant cell arteritis. Skip lesion. How long after starting systemic steroid can biopsy still be useful for showing giant cell arteritis? (Answer: within one week of starting steroid)
• How do you perform giant cell biopsy?