Difference between revisions of "Chorangiosis"

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#redirect [[Placenta#Chorangiosis]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Chorangiosis_-_high_mag.jpg
| Width      =
| Caption    = Chorangiosis. [[H&E stain]].
| Micro      = increased blood vessels in the terminal villi, diffuse
| Subtypes  =
| LMDDx      = [[placental villous immaturity]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = not apparent on gross
| Grossing  =
| Site      = [[placenta]]
| Assdx      = [[diabetes mellitus]], gestational diabetes, [[smoking]], [[IUGR]]
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
}}
'''Chorangiosis''' is a relatively common [[placental pathology]]. It should '''not''' be confused with [[chorangioma]].
 
==General==
*Relative common among babies in ICU ~5%.<ref>URL: [http://www.bhj.org/journal/2009_5102_april/download/pg251-252.pdf http://www.bhj.org/journal/2009_5102_april/download/pg251-252.pdf]. Accessed on: 26 July 2011.</ref>
*Increased fetal morbidity and mortality.<ref name=pmid22222282>{{Cite journal  | last1 = Barut | first1 = A. | last2 = Barut | first2 = F. | last3 = Kandemir | first3 = NO. | last4 = Aktunc | first4 = E. | last5 = Arikan | first5 = I. | last6 = Harma | first6 = M. | last7 = Harma | first7 = MI. | last8 = Gun | first8 = BD. | title = Placental chorangiosis: the association with oxidative stress and angiogenesis. | journal = Gynecol Obstet Invest | volume = 73 | issue = 2 | pages = 141-51 | month =  | year = 2012 | doi = 10.1159/000332370 | PMID = 22222282 }}</ref>
 
Associations:
*Maternal hypoxia:
**[[Smoking]].
**High altitude.<ref name=pmid8743160>{{Cite journal  | last1 = Soma | first1 = H. | last2 = Watanabe | first2 = Y. | last3 = Hata | first3 = T. | title = Chorangiosis and chorangioma in three cohorts of placentas from Nepal, Tibet, and Japan. | journal = Reprod Fertil Dev | volume = 7 | issue = 6 | pages = 1533-8 | month =  | year = 1995 | doi =  | PMID = 8743160 }}</ref>
**Diabetes:
***Gestational [[diabetes]].<ref name=pmid18382864>{{Cite journal  | last1 = Daskalakis | first1 = G. | last2 = Marinopoulos | first2 = S. | last3 = Krielesi | first3 = V. | last4 = Papapanagiotou | first4 = A. | last5 = Papantoniou | first5 = N. | last6 = Mesogitis | first6 = S. | last7 = Antsaklis | first7 = A. | title = Placental pathology in women with gestational diabetes. | journal = Acta Obstet Gynecol Scand | volume = 87 | issue = 4 | pages = 403-7 | month =  | year = 2008 | doi = 10.1080/00016340801908783 | PMID = 18382864 }}</ref>
***[[Diabetes mellitus]] type 1.<ref name=pmid13129678>{{Cite journal  | last1 = Evers | first1 = IM. | last2 = Nikkels | first2 = PG. | last3 = Sikkema | first3 = JM. | last4 = Visser | first4 = GH. | title = Placental pathology in women with type 1 diabetes and in a control group with normal and large-for-gestational-age infants. | journal = Placenta | volume = 24 | issue = 8-9 | pages = 819-25 | month =  | year =  | doi =  | PMID = 13129678 }}</ref>
 
==Gross==
*Usually not seen on gross pathology.
 
==Microscopic==
Features:
*Increased blood vessels in the terminal villi.
**Altshuler criteria: "a minimum of 10 villi, each with 10 or more vascular channels, in 3 or more random, non-infarcted placental areas when using a ×10 ocular."<ref name=pmid6546343>{{Cite journal  | last1 = Altshuler | first1 = G. | title = Chorangiosis. An important placental sign of neonatal morbidity and mortality. | journal = Arch Pathol Lab Med | volume = 108 | issue = 1 | pages = 71-4 | month = Jan | year = 1984 | doi =  | PMID = 6546343 }}</ref><ref name=pmid11520290/><ref>URL: [http://path.upmc.edu/cases/case655/dx.html http://path.upmc.edu/cases/case655/dx.html]. Accessed on: 28 January 2012.</ref>
***The definition suffers from [[IPFitis]].
*Lesion ''not'' well circumscribed.
*Villi tend to be larger and have centrally placed blood vessels.<ref>E. Latta. 26 July 2011.</ref>
 
Notes:
*Normal villi have up to five vascular channels.<ref name=pmid11520290>{{Cite journal  | last1 = De La Ossa | first1 = MM. | last2 = Cabello-Inchausti | first2 = B. | last3 = Robinson | first3 = MJ. | title = Placental chorangiosis. | journal = Arch Pathol Lab Med | volume = 125 | issue = 9 | pages = 1258 | month = Sep | year = 2001 | doi = 10.1043/0003-9985(2001)1251258:PC2.0.CO;2 | PMID = 11520290 | url=http://www.archivesofpathology.org/doi/full/10.1043/0003-9985%282001%29125%3C1258:PC%3E2.0.CO;2}}</ref>
 
DDx:
*[[Placental villous immaturity]].
 
===Images===
<gallery>
Image:Chorangiosis_-_intermed_mag.jpg | Chorangiosis - intermed. mag. (WC)
Image:Chorangiosis_-_high_mag.jpg | Chorangiosis - high mag. (WC)
</gallery>
 
==Sign out==
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- PLACENTAL DISC WITH CHORANGIOSIS.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
 
COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or
high altitude.
</pre>
 
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- PLACENTAL DISC WITH:
-- CHORANGIOSIS.
-- FOCAL PERIVILLOUS FIBRIN DEPOSITION.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
 
COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or high altitude.
</pre>
 
===Chorangiosis and meconium===
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN MECONIUM STAINING OF THE AMNION, NEGATIVE FOR CHORIOAMNIONITIS.
- PLACENTAL DISC WITH:
-- CHORANGIOSIS.
-- FOCAL PERIVILLOUS FIBRIN DEPOSITION.
 
COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or high altitude.
</pre>
 
==See also==
*[[Placenta]].
*[[Placental villous immaturity]].
 
==References==
{{Reflist|2}}
 
[[Category:Placenta]]
[[Category:Diagnosis]]

Latest revision as of 18:04, 12 February 2015

Chorangiosis
Diagnosis in short

Chorangiosis. H&E stain.
LM increased blood vessels in the terminal villi, diffuse
LM DDx placental villous immaturity
Gross not apparent on gross
Site placenta
Associated Dx diabetes mellitus, gestational diabetes, smoking, IUGR

Chorangiosis is a relatively common placental pathology. It should not be confused with chorangioma.

General

  • Relative common among babies in ICU ~5%.[1]
  • Increased fetal morbidity and mortality.[2]

Associations:

Gross

  • Usually not seen on gross pathology.

Microscopic

Features:

  • Increased blood vessels in the terminal villi.
    • Altshuler criteria: "a minimum of 10 villi, each with 10 or more vascular channels, in 3 or more random, non-infarcted placental areas when using a ×10 ocular."[6][7][8]
      • The definition suffers from IPFitis.
  • Lesion not well circumscribed.
  • Villi tend to be larger and have centrally placed blood vessels.[9]

Notes:

  • Normal villi have up to five vascular channels.[7]

DDx:

Images

  • Chorangiosis - intermed. mag. (WC)

  • Chorangiosis - high mag. (WC)

Sign out

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- PLACENTAL DISC WITH CHORANGIOSIS.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or
high altitude.

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- PLACENTAL DISC WITH:
-- CHORANGIOSIS.
-- FOCAL PERIVILLOUS FIBRIN DEPOSITION.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or high altitude.

Chorangiosis and meconium

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION:
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN MECONIUM STAINING OF THE AMNION, NEGATIVE FOR CHORIOAMNIONITIS.
- PLACENTAL DISC WITH:
-- CHORANGIOSIS.
-- FOCAL PERIVILLOUS FIBRIN DEPOSITION.

COMMENT:
Chorangiosis is a nonspecific finding that may be associated with diabetes, smoking or high altitude.

See also

References

  1. ↑ URL: http://www.bhj.org/journal/2009_5102_april/download/pg251-252.pdf. Accessed on: 26 July 2011.
  2. ↑ Barut, A.; Barut, F.; Kandemir, NO.; Aktunc, E.; Arikan, I.; Harma, M.; Harma, MI.; Gun, BD. (2012). "Placental chorangiosis: the association with oxidative stress and angiogenesis.". Gynecol Obstet Invest 73 (2): 141-51. doi:10.1159/000332370. PMID 22222282.
  3. ↑ Soma, H.; Watanabe, Y.; Hata, T. (1995). "Chorangiosis and chorangioma in three cohorts of placentas from Nepal, Tibet, and Japan.". Reprod Fertil Dev 7 (6): 1533-8. PMID 8743160.
  4. ↑ Daskalakis, G.; Marinopoulos, S.; Krielesi, V.; Papapanagiotou, A.; Papantoniou, N.; Mesogitis, S.; Antsaklis, A. (2008). "Placental pathology in women with gestational diabetes.". Acta Obstet Gynecol Scand 87 (4): 403-7. doi:10.1080/00016340801908783. PMID 18382864.
  5. ↑ Evers, IM.; Nikkels, PG.; Sikkema, JM.; Visser, GH.. "Placental pathology in women with type 1 diabetes and in a control group with normal and large-for-gestational-age infants.". Placenta 24 (8-9): 819-25. PMID 13129678.
  6. ↑ Altshuler, G. (Jan 1984). "Chorangiosis. An important placental sign of neonatal morbidity and mortality.". Arch Pathol Lab Med 108 (1): 71-4. PMID 6546343.
  7. ↑ 7.0 7.1 De La Ossa, MM.; Cabello-Inchausti, B.; Robinson, MJ. (Sep 2001). "Placental chorangiosis.". Arch Pathol Lab Med 125 (9): 1258. doi:10.1043/0003-9985(2001)1251258:PC2.0.CO;2. PMID 11520290. http://www.archivesofpathology.org/doi/full/10.1043/0003-9985%282001%29125%3C1258:PC%3E2.0.CO;2.
  8. ↑ URL: http://path.upmc.edu/cases/case655/dx.html. Accessed on: 28 January 2012.
  9. ↑ E. Latta. 26 July 2011.
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