Difference between revisions of "Placenta"

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*The above time course is disputed - in vitro experiments suggest it is considerably longer.<ref name=pmid19031358>{{cite journal |author=Funai EF, Labowsky AT, Drewes CE, Kliman HJ |title=Timing of fetal meconium absorption by amnionic macrophages |journal=Am J Perinatol |volume=26 |issue=1 |pages=93–7 |year=2009 |month=January |pmid=19031358 |doi=10.1055/s-0028-1103028 |url=}}</ref>
*The above time course is disputed - in vitro experiments suggest it is considerably longer.<ref name=pmid19031358>{{cite journal |author=Funai EF, Labowsky AT, Drewes CE, Kliman HJ |title=Timing of fetal meconium absorption by amnionic macrophages |journal=Am J Perinatol |volume=26 |issue=1 |pages=93–7 |year=2009 |month=January |pmid=19031358 |doi=10.1055/s-0028-1103028 |url=}}</ref>


 
====Images====
Images:
<gallery>
*[http://commons.wikimedia.org/wiki/File:Meconium-laden_macrophages_high_mag.jpg Meconium-laden macrophages - high mag. (WC)].
Image:Meconium-laden_macrophages_high_mag.jpg | Meconium-laden macrophages - high mag. (WC)
*[http://commons.wikimedia.org/wiki/File:Meconium-laden_macrophages_intermed_mag.jpg Meconium-laden macrophages - intermed. mag. (WC)].
Image:Meconium-laden_macrophages_intermed_mag.jpg | Meconium-laden macrophages - intermed. mag. (WC)
 
</gallery>
===Special stains===
===Special stains===
*Hemosiderin +ve in hemosiderin-laden macrophages.
*Hemosiderin +ve in hemosiderin-laden macrophages.
Line 641: Line 641:
*[[Chorangiosis]].
*[[Chorangiosis]].


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Placental_villous_immaturity_-_low_mag.jpg Placental villous immaturity - low mag. (WC)].
Image:Placental_villous_immaturity_-_low_mag.jpg |Placental villous immaturity - low mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Placental_villous_immaturity_-_intermed_mag.jpg Placental villous immaturity - intermed. mag. (WC)].
Image:Placental_villous_immaturity_-_intermed_mag.jpg |Placental villous immaturity - intermed. mag. (WC)
 
</gallery>
=Diseases of the placental attachment=
=Diseases of the placental attachment=
==Placenta creta==
==Placenta creta==
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*Severe cases may have umbilical cord vasculitis or [[funisitis]].
*Severe cases may have umbilical cord vasculitis or [[funisitis]].


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Chorioamnionitis_-_low_mag.jpg Chorioamnionitis - low mag. (WC)].
Image:Chorioamnionitis_-_low_mag.jpg | Chorioamnionitis - low mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Chorioamnionitis_-_high_mag.jpg Chorioamnionitis - high mag. (WC)].
Image:Chorioamnionitis_-_high_mag.jpg | Chorioamnionitis - high mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Chorioamnionitis_-2-_very_high_mag.jpg Chorioamnionitis - very high mag. (WC)].
Image:Chorioamnionitis_-2-_very_high_mag.jpg | Chorioamnionitis - very high mag. (WC)
 
</gallery>
====Grading chorioamnionitis====
====Grading chorioamnionitis====
Chorioamnionitis:<ref name=Ref_Sternberg4_2311>{{Ref Sternberg4|2311}}</ref>
Chorioamnionitis:<ref name=Ref_Sternberg4_2311>{{Ref Sternberg4|2311}}</ref>
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**Plasma cells may be seen in the decidua -- these can be ignored.
**Plasma cells may be seen in the decidua -- these can be ignored.


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Villitis_of_unknown_etiology_-_intermed_mag.jpg VUE - intermed. mag. (WC)].
Image:Villitis_of_unknown_etiology_-_intermed_mag.jpg | VUE - intermed. mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Villitis_of_unknown_etiology_-_very_high_mag.jpg VUE - very high mag. (WC)].
Image:Villitis_of_unknown_etiology_-_very_high_mag.jpg | VUE - very high mag. (WC)
*www:
</gallery>
**[http://jcp.bmj.com/content/61/12/1254/F6.large.jpg VUE (bmj.com)].<ref>URL: [http://jcp.bmj.com/content/61/12/1254.abstract http://jcp.bmj.com/content/61/12/1254.abstract]. Accessed on: 11 January 2011.</ref>
www:
*[http://jcp.bmj.com/content/61/12/1254/F6.large.jpg VUE (bmj.com)].<ref>URL: [http://jcp.bmj.com/content/61/12/1254.abstract http://jcp.bmj.com/content/61/12/1254.abstract]. Accessed on: 11 January 2011.</ref>
**[http://farm4.static.flickr.com/3501/3954021698_84a3542b43.jpg VUE (flickr.com)].<ref name=jian>URL: [http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/ http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/]. Accessed on: 11 January 2011.</ref>
**[http://farm4.static.flickr.com/3501/3954021698_84a3542b43.jpg VUE (flickr.com)].<ref name=jian>URL: [http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/ http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/]. Accessed on: 11 January 2011.</ref>
**[http://www.flickr.com/photos/jian-hua_qiao_md/3954022678/in/photostream/ VUE (flickr.com)].<ref name=jian>URL: [http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/ http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/]. Accessed on: 11 January 2011.</ref>
*[http://www.flickr.com/photos/jian-hua_qiao_md/3954022678/in/photostream/ VUE (flickr.com)].<ref name=jian>URL: [http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/ http://www.flickr.com/photos/jian-hua_qiao_md/3954021698/]. Accessed on: 11 January 2011.</ref>


==Chronic intervillitis==
==Chronic intervillitis==
Line 923: Line 924:
*Fibrinoid deposition.
*Fibrinoid deposition.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Intervillitis_-_intermed_mag.jpg Intervillitis - intermed. mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Intervillitis_-_very_high_mag.jpg Intervillitis - very high mag. (WC)].
Image:Intervillitis_-_intermed_mag.jpg | Intervillitis - intermed. mag. (WC)
 
Image:Intervillitis_-_very_high_mag.jpg | Intervillitis - very high mag. (WC)
</gallery>
==Chronic deciduitis==
==Chronic deciduitis==
*[[AKA]] plasma cell deciduitis.
*[[AKA]] plasma cell deciduitis.
Line 940: Line 942:
*Decidua = maternal tissue.
*Decidua = maternal tissue.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Chronic_deciduitis_-_intermed_mag.jpg Chronic deciduitis - intermed. mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Chronic_deciduitis_-_very_high_mag.jpg Chronic deciduitis - very high mag. (WC)].
Image:Chronic_deciduitis_-_intermed_mag.jpg | Chronic deciduitis - intermed. mag. (WC)
 
Image:Chronic_deciduitis_-_very_high_mag.jpg | Chronic deciduitis - very high mag. (WC)
</gallery>
=Placental infarction=
=Placental infarction=
==True infarcts==
==True infarcts==
Line 980: Line 983:
#**Vessel wall lipid deposition.
#**Vessel wall lipid deposition.


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Placental_infarct_-_low_mag.jpg Placental infarct - low mag. (WC)].
Image:Placental_infarct_-_low_mag.jpg | Placental infarct - low mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Placental_infarct_-_intermed_mag.jpg Placental infarct - intermed. mag. (WC)].
Image:Placental_infarct_-_intermed_mag.jpg | Placental infarct - intermed. mag. (WC)
*www:
</gallery>
**[http://pathweb.uchc.edu/eatlas/gyn/1203b.htm Recent infarct (pathweb.uchc.edu)].
www:
**[http://path.upmc.edu/cases/case75/images/micro1.jpg Placental infarct (umpmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case75/micro.html http://path.upmc.edu/cases/case75/micro.html]. Accessed on: 6 January 2011.</ref>
*[http://pathweb.uchc.edu/eatlas/gyn/1203b.htm Recent infarct (pathweb.uchc.edu)].
**[http://www.mda-sy.com/pathology/PLACHTML/PLAC024.HTM Placental infarct - necrotic villi (mda-sy.com)].
*[http://path.upmc.edu/cases/case75/images/micro1.jpg Placental infarct (umpmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case75/micro.html http://path.upmc.edu/cases/case75/micro.html]. Accessed on: 6 January 2011.</ref>
*[http://www.mda-sy.com/pathology/PLACHTML/PLAC024.HTM Placental infarct - necrotic villi (mda-sy.com)].


===Sign out===
===Sign out===
Line 1,112: Line 1,116:
**This is a chronic change.
**This is a chronic change.


Images:
====Images====
*www:
www:
**[http://jcp.bmj.com/content/61/12/1254/F8.large.jpg FTV (bmj.com)].<ref>URL: [http://jcp.bmj.com/content/61/12/1254.abstract http://jcp.bmj.com/content/61/12/1254.abstract]. Accessed on: 12 January 2011.</ref>
*[http://jcp.bmj.com/content/61/12/1254/F8.large.jpg FTV (bmj.com)].<ref>URL: [http://jcp.bmj.com/content/61/12/1254.abstract http://jcp.bmj.com/content/61/12/1254.abstract]. Accessed on: 12 January 2011.</ref>
**[http://gut.bmj.com/content/41/3/354/F3.large.jpg Thrombus - rat (bmj.com)].<ref>URL: [http://gut.bmj.com/content/41/3/354.full http://gut.bmj.com/content/41/3/354.full]. Accessed on: 12 January 2011.</ref>
*[http://gut.bmj.com/content/41/3/354/F3.large.jpg Thrombus - rat (bmj.com)].<ref>URL: [http://gut.bmj.com/content/41/3/354.full http://gut.bmj.com/content/41/3/354.full]. Accessed on: 12 January 2011.</ref>
**[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4a.jpg FTV - low mag. (womenandinfants.org)].<ref>URL: [http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm]. Accessed on: 17 December 2012.</ref>
*[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4a.jpg FTV - low mag. (womenandinfants.org)].<ref>URL: [http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm]. Accessed on: 17 December 2012.</ref>
**[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4b.jpg FTV - high mag. (womenandinfants.org)].
*[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4b.jpg FTV - high mag. (womenandinfants.org)].
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Fetal_thrombotic_vasculopathy_-_intermed_mag.jpg FTV - intermed. mag. (WC)].
Image:Fetal_thrombotic_vasculopathy_-_intermed_mag.jpg | FTV - intermed. mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Fetal_thrombotic_vasculopathy_-_high_mag.jpg FTV - high mag. (WC)].
Image:Fetal_thrombotic_vasculopathy_-_high_mag.jpg | FTV - high mag. (WC)
 
</gallery>
==Hemorrhagic endovasculitis==
==Hemorrhagic endovasculitis==
*Abbreviated ''HEV''.
*Abbreviated ''HEV''.
Line 1,172: Line 1,176:
*''Smooth muscle hypertrophy'' can also be understood as ''lack of physiological conversion of spiral arteries of the uterus''.<ref name=pmid12848643>{{Cite journal  | last1 = Naicker | first1 = T. | last2 = Khedun | first2 = SM. | last3 = Moodley | first3 = J. | last4 = Pijnenborg | first4 = R. | title = Quantitative analysis of trophoblast invasion in preeclampsia. | journal = Acta Obstet Gynecol Scand | volume = 82 | issue = 8 | pages = 722-9 | month = Aug | year = 2003 | doi =  | PMID = 12848643 }}</ref>
*''Smooth muscle hypertrophy'' can also be understood as ''lack of physiological conversion of spiral arteries of the uterus''.<ref name=pmid12848643>{{Cite journal  | last1 = Naicker | first1 = T. | last2 = Khedun | first2 = SM. | last3 = Moodley | first3 = J. | last4 = Pijnenborg | first4 = R. | title = Quantitative analysis of trophoblast invasion in preeclampsia. | journal = Acta Obstet Gynecol Scand | volume = 82 | issue = 8 | pages = 722-9 | month = Aug | year = 2003 | doi =  | PMID = 12848643 }}</ref>


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Hypertrophic_decidual_vasculopathy_intermed_mag.jpg HDV - intermed. mag. (WC)].
Image:Hypertrophic_decidual_vasculopathy_intermed_mag.jpg | HDV - intermed. mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Hypertrophic_decidual_vasculopathy_low_mag.jpg HDV - low mag. (WC)].
Image:Hypertrophic_decidual_vasculopathy_low_mag.jpg | HDV - low mag. (WC)
*www:
</gallery>
**[http://path.upmc.edu/cases/case75/images/micro2.jpg Atherosis (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case75.html http://path.upmc.edu/cases/case75.html]. Accessed on: 2 January 2012.</ref>
www:
*[http://path.upmc.edu/cases/case75/images/micro2.jpg Atherosis (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case75.html http://path.upmc.edu/cases/case75.html]. Accessed on: 2 January 2012.</ref>


==HELLP syndrome==
==HELLP syndrome==
Line 1,204: Line 1,209:
*[[RBC]]s with basophilic dots ~1-2 micrometres.
*[[RBC]]s with basophilic dots ~1-2 micrometres.


Image:
====Image====
*[http://commons.wikimedia.org/wiki/File:Maternal_malaria_placenta_-_very_high_mag.jpg Maternal malaria - very high mag. (WC)].
<gallery>
 
Image:Maternal_malaria_placenta_-_very_high_mag.jpg | Maternal malaria - very high mag. (WC)
</gallery>
=Tumours=
=Tumours=
{{main|Gestational trophoblastic disease}}
{{main|Gestational trophoblastic disease}}
Line 1,231: Line 1,237:
*+/-High cellularity.
*+/-High cellularity.
*+/-Degenerative changes.
*+/-Degenerative changes.
Images:
*[http://commons.wikimedia.org/wiki/File:Chorangioma_-_intermed_mag.jpg Chorangioma - intermed. mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Chorangioma_-_low_mag.jpg Chorangioma - low mag. (WC)].


Notes:
Notes:
*Must be differentiated from [[chorangiomatosis]] (associated with preeclampsia & IUGR) and chorangiosis (assoc. with maternal [[diabetes mellitus]]).<ref name=pmid20594143/>
*Must be differentiated from [[chorangiomatosis]] (associated with preeclampsia & IUGR) and chorangiosis (assoc. with maternal [[diabetes mellitus]]).<ref name=pmid20594143/>
 
====Images====
<gallery>
Image:Chorangioma_-_intermed_mag.jpg | Chorangioma - intermed. mag. (WC)
Image:Chorangioma_-_low_mag.jpg | Chorangioma - low mag. (WC)
</gallery>
==Chorangiomatosis==
==Chorangiomatosis==
===General===
===General===
Line 1,280: Line 1,286:
*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>
*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>


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Chorangiosis_-_intermed_mag.jpg Chorangiosis - intermed. mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Chorangiosis_-_high_mag.jpg Chorangiosis - high mag. (WC)].
Image:Chorangiosis_-_intermed_mag.jpg | Chorangiosis - intermed. mag. (WC)
 
Image:Chorangiosis_-_high_mag.jpg | Chorangiosis - high mag. (WC)
</gallery>
===Sign out===
===Sign out===
<pre>
<pre>
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