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Category Archives: Placenta
Villitis
Villitis
- can be acute or chronic
neutrophils often present in Listeria
plasma cells often in Chlamydia
nuclear/cytoplasmic inclusions = HSV (nucleus only), CMV
granulomatous inflammation see in TB, fungi, infection
lymphocytes, macrophages present in VUE (villitis of unknown etiology)
Posted in Placenta
Tagged Placental villi infection, Placental Villitis, Villitis, villitis of unknown etiology, Villus infection, VUE
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Placental Infections
Placental Infections
Organisms: TORCHS
Acute Funisitis
- inflammation of the umbilical cord
- neutrophils present in the umbilical cord blood bessels
Posted in Placenta
Tagged Acute funisitis, Funisitis, Placenta, Placenta infection, TORCH, TORCH infections
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Placenta Chorioamnionitis
Placenta Chorioamnionitis
- usually secondary to bacteria (Group B Streptococcus, E. coli, Staphylococcus)
- PID, peritubal adhesions from appendicitis
Posted in Placenta
Tagged Chorioamnionitis, E. coli, Group B Streptococcus, Staphylococcus, Streptococcus
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Placental Cord Insertion Sites
Placental Cord Insertion Sites
Types of Cord Insertion
Central Placental Cord Insertion
Eccentric Placental Cord Insertion
Velamentous Placental Cord Insertion
- membrane insertion
Circummarginate Placental Cord Insertion
- insertion at edge
Circumvallate Placental Cord Insertion
- insertion at edge with membranes folding back on themselves
- associated clinical complications (eg. intrauterine growth retardation IUGR)
Posted in Placenta
Tagged Central, Circummarginate, Circumvallate, Cord Insertion, Eccentric, Placenta Cord Insertion, Placental Cord Insertion, Placental Cord Insertion Sites, Types of Cord Insertion, Velamentous
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Abnormal Placentation
Types of Abnormal Placentation
Placenta accreta (villi adhere to myometrium – no intervening layer of decidua)
Placenta increta (villi in between myometrium)
Placenta percreta (villi through the entire thickness of the myometrium)
Posted in Placenta
Tagged Abnormal Placentation, Abnormal Placentation Types, Placenta, Placenta accreta, Placenta increta, Placenta percreta, Types of Abnormal Placentation
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Chorangioma
Chorangioma
- placental hemangioma
Amnion Nodosum
Amnion Nodosum
- secondary to oligohydramnios
- small nodules proteinaceous material with entrapped squames
Placental Site Trophoblastic Tumor
Placental Site Trophoblastic Tumor
- tumor of intermediate trophoblasts
Etiology: 75 % follow normal pregnancy – need paternal X chromosome
Clinical: poor response to chemotherapy → so hysterectomy (TAH), low hCG
Gross: dark, red hemorrhagic nodular tumor
Histology
- infiltration of the myometrium by intermediate trophoblasts (hPL strongly positive)
- abundunt eosinophilic cytoplasm with nuclear pleomophism
- deposition of fibrinoid material, vessels
Immunohistochemistry
- hPL strong, focal hCG, CK
Posted in Placenta
Tagged hPL, intermediate trophoblast, Placental site trophoblastic tumor, PSTT, tumor of intermediate trophoblasts
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Choriocarcinoma
Choriocarcinoma
Etiology: 2.5 % of complete moles, persistent hCG production
Clinical: good response to chemotherapy, high hCG
Gross appearance: dark, red hemorrhagic nodular tumor mass
Histology:
- cytotrophoblast and syncytiotrophoblast, biphasic tumor
- no villi
- blood vessel invasion with metastases to lung, brain, liver,
Immunohistochemistry
- hCG CK18, cytokeratin,
Poor prognostic factors:
> 4 months, hCG >40 000, brain or liver metstases, GTD post term gestation
Posted in Placenta
Tagged biphasic tumor, Choriocarcinoma, CK18, cytotrophoblast, hCG, persistent hCG, syncytiotrophoblast
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Invasive Mole
Invasive Mole
- 15% of complete moles are invasive
- usually complete hydatidiform mole
- invades into the myometrium and/or blood vessels
- self limited usually regresses
Complications:
- hemorrhage, perforation, metastases to lung, brain,
- continues to produce hCG
Posted in Placenta
Tagged Complete hydatidiform mole, Hydatidiform mole, Invasive Hydatidiform Mole, Invasive mole, Partial hydatidiform mole
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