Case 228. 
EBV-induced inflammatory coronary aneurysm (21 y-o M)
         
    Autopsied heart with coronary aneurysm in case of chronic active EBV infection    
         
   
Key words : EBV, coronary aneurysm, chronic active EBV infeciton
   
     
 
     
The wall of coronary artery shows fibrotic scarring with focal lymphocytic infiltration around the vasa vasorum. The thickened intima reveals atheromatous change (HE, low power).   Elastica van Gieson stain demonstrates marked destruction of the medial elastic fibers and extensive fibrosis of the intima and adventitia.
     
 
     
Lymphocytic infiltation around the vasa vasorum in the scarred coronary arterial wall is demonstrated (HE, higher power).   EBER-1 reactivity is observed in the nuclei of some of the small lymphocytes around the vasa vasorum (in situ hybridization). The inflammatory aneurysm resembles the lesion of Kawasaki's disease.