Nodules of Arantius

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A Moment in History

Georg Eduard Von Rindfleisch
(1836 – 1908)

German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999) Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross

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Details: Written by: Efrain A. Miranda, Ph.D.; Published: January 20, 2015; Hits: 43211

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The eponymic nodules (or nodes) of Arantius are thickenings of the tunica intima layer covering the ventricular aspect of the leaflets of the aortic valve, also known as the ventricularis layer (see blue arrows in the accompanying image). The thickening happens at the point of coaptation of all three leaflets. The shape and size of these growths varies from person to person and with age. The proper name for these structures is “nodes of the semilunar cusps” or “noduli valvularium semilunarium valvae aortae” in Latin

The portion of the leaflet proximal to the node of Arantius is the load-bearing portion and the portion of the leaflet distal to the node of Arantius is non-functional and is known as the “lunule”

Hypertrophy of the node of Arantius is not common, but when present and excessive it can lead to aortic valve dysfunction and insufficiency.

These excrescences of the valve leaflets are named after Giulio Cesare Aranzio (1530 – 1589), an Italian anatomist better known by his Latinized name Arantius.

Although most anatomists and surgeons use the same eponym for the excrescences of the pulmonary valve, those should be called the “nodes of Morgagni” after Giovanni Batista Morgagni (1682 - 1771) or "Noduli valvularum semilunarium valvae trunci pulmonalis" in Latin

Sources:
1. “The surface anatomy of the human aortic valve as revealed by scanning electron microscopy.” Hurle, JM et al Anat Embryol (Berl). 1985;172(1):61-7
2. “Hypertrophy of nodules of Arantius and aortic insufficiency: pathophysiology and repair.” Shapira, N et al Ann Thorac Surg. 1991 Jun;51(6):969-72
3. "The origin of Medical Terms" Skinner, AH, 1970
4. "Terminologia Anatomica: International Anatomical Terminology (FCAT)" Thieme, 1998
5. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
Image property of: CAA.Inc.. Photographer: D.M. Klein

Nodules of Arantius

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