Aortopulmonary window

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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: Prof. C. Uribe; Published: October 27, 2015; Hits: 5683

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Anatomy: The term [aortopulmonary window] is a radiological term that refers to a small space in the left mediastinal region. It is bounded anteriorly by the ascending aorta, posteriorly by the descending aorta, superiorly by the aortic arch, inferiorly by the left pulmonary artery, medially by the arterial ligament [ligamentum arteriosum] and left main bronchus, and laterally by the pleura and left lung. It contents the recurrent laryngeal nerve, lymph nodes, and adipose tissue.

Clinical: The aortopulmonary window is commonplace for lymphadenopathy in various inflammatory and neoplastic diseases.

Radiology: In a frontal projection, it corresponds to a focal concavity on the left border of the mediastinum, inferior to the aorta and superior to the left pulmonary artery. In the lateral projection (which is the proper image to identify this area), it is seen as a radiolucency inferior to the aortic arch and superior to the left pulmonary artery. Its appearance can be modified by tortuosity of the aorta.

Congenital heart disease: This term also refers to a congenital heart disease similar in appearance to patent ductus arteriosus, (or truncus arteriosus) with the difference that this involves septal defect. It is described as a communication between the ascending aorta and pulmonary trunk portion or right pulmonary artery. It is a rare anomaly that represents 0.2% -0.6% of congenital cardiac abnormalities.

Sources:
1. Heitzman ER. The infraaortic area. In: The mediastinum: With correlations radiologic anatomy and pathology. Berlin, Germany: Springer-Verlag, 1988; 151: -168.
2. Blank N, Castellino RA. Patterns of pleural reflections of the left upper mediastinum: Normal anatomy and distortions produced by adenopathy. Radiology 1972; 102: 585-589.
3. Marc Dewey, Donna Magid, Paul S. Wheeler and Bernd Hamm aortopulmonary Angle Window or on the Chest Radiograph? American Journal of Roentgenology. 2004; 182: 1085-1086.
4. SY Ho, Gerlis LM, Anderson C, Devine WA, Smith A. The morphology of aortopulmonary windows With regard to their classification and morphogenesis. Young Cardiol 1994; 4: 146-55.
5. Kutsche LM, Van Mierop LHS. Anatomy and pathogenesis of aorticopulmonary septal defect. Am J Cardiol 1987; 59: 443-7.
6. Stevenson, Roger E .; Hall, Judith G. (2006). Human malformations and related anomalies. Oxford University Press US. pp. 119-. ISBN 978-0-19-516568-5
7. Donoghue, Veronica B .; Bj?rnstad, Per G. Radiological Imaging of the Neonatal Chest. Springer. pp. 330-. ISBN 978-3-540-33748-5.

Aortopulmonary window

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