Morphological findings in idiopathic calcification of the ascending aorta and aortic valve affecting a young woman

The pathology of a case of idiopathic calcification affecting the ascending aorta in a young woman is presented. A varying width of media throughout the aorta and extending into its proximal branches was devoid of cell nuclei (medial necrosis) although elastic lamellae persisted. Plaques of calcium, found in the acellular media, were confined to the ascending aorta. No inflammatory or reparative reaction was seen in the vessel wall. Electron microscopically, the calcium seemed to have an affinity for elastic tissue elements of all sizes and the mode of deposition appeared to be by ‘avenues’ of the microfibrillar component Possible pathogenetic mechanisms are discussed.