Temporal arteritis in a young patient

Temporal arteritis in the young is clinically and histologically different from classic giant cell arteritis of the elderly population. A male patient, aged 36 years, presented with headache and a nodule in his left temporal region. Histological examination of the nodule showed that the left temporal artery was encircled by a lymphoid tissue with prominent germinal centres. The arterial wall was infiltrated with mixed inflammatory cells, the internal elastic lamina was disrupted, and there was marked intimal hyperplasia. The patient was diagnosed with juvenile temporal arteritis. Because of persistent headache after surgical excision of the lesion, the patient was treated with prednisolone. Systemic vasculitides, classic giant cell arteritis, Kimura's disease, and angiolymphoid hyperplasia with eosinophilia should be considered in the differential diagnosis of the disease.