Fig

The aortic root is widened here and the commissures of the aortic valve cusps are pulled apart. The aorta above this shows peculiar wrinkling that is typical for syphilitic aortitis. The widening of the root can cause aortic insufficiency and also aneurysmal dilation of the ascending aorta. Such dilation may also be seen with Marfan's syndrome, but the intima would not show the wrinkling.
Syphilitic aneurysm


The surface of the aorta shows wrinkling or "tree-barking" that is typical for syphilitic aortitis. The aortitis involves the vasa vasora and leads to focal medial loss that produces the wrinkling.
Syphilitic aneurysm


A case of syphilitic aortitis showing lymphoplasmacytic infiltration of the vasa vasorum within the aortic adventitia.
Syphilitic aortitis