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Placenta (view source)

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===Linear regression - placental mass-gestational age===
===Linear regression - placental mass-gestational age===
Based on the table in the AFIP book<ref>AFIP Placental pathol. ISBN: 1-881041-89-1. P.312</ref> I generated the following regression lines:
Based on the table in the AFIP book<ref>AFIP Placental pathol. ISBN: 1-881041-89-1. P.312</ref> one can generate the following regression lines:
{| class="wikitable"
{| class="wikitable"
| ||'''50%''' ||'''10%''' ||'''90%'''
| ||'''50%''' ||'''10%''' ||'''90%'''
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*Is it required?
*Is it required?
**Sebire and Fox have advocated abandoning the practise of obtaining a placental mass, due to the large number of uncontrolled variables inherent in these measures.  Instead, they have advocated using mushy descriptors such as "small", "average" and "large", which require experience in examining the organ.<ref>{{cite book |author= Fox, Harold; Sebire, Neil J. |title=[http://www.amazon.com/Pathology-Placenta-Major-Problems/dp/1416025928/ref=sr_1_fkmr0_1?ie=UTF8&qid=1297259619&sr=1-1-fkmr0 Pathology of the Placenta (Major Problems in Pathology)]|publisher=Saunders |location= |year=2007 |pages= 559-561 |edition=3rd |isbn=978-1416025924 |oclc= |doi= |accessdate=}}</ref>   
**Sebire and Fox have advocated abandoning the practise of obtaining a placental mass, due to the large number of uncontrolled variables inherent in these measures.  Instead, they have advocated using mushy descriptors such as "small", "average" and "large", which require experience in examining the organ.<ref>{{cite book |author= Fox, Harold; Sebire, Neil J. |title=[http://www.amazon.com/Pathology-Placenta-Major-Problems/dp/1416025928/ref=sr_1_fkmr0_1?ie=UTF8&qid=1297259619&sr=1-1-fkmr0 Pathology of the Placenta (Major Problems in Pathology)]|publisher=Saunders |location= |year=2007 |pages= 559-561 |edition=3rd |isbn=978-1416025924 |oclc= |doi= |accessdate=}}</ref>   
***In the context of quality, a measure (even if somewhat flawed), is almost certainly more reproducible than arbitrary descriptors which require experience and a continuing case volume to calibrate.
***In the context of quality, a measure (even if somewhat flawed) is probably more reproducible and objective than arbitrary descriptors which require experience and a continuing case volume to calibrate.


===Placentomegaly===
===Placentomegaly===
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*Rare ~ 1/5500.
*Rare ~ 1/5500.
*Mortality ~50% is severe.
*Mortality ~50% is severe.
Image: [http://flylib.com/books/2/953/1/html/2/43%20-%20Placenta_files/DA10C43FF12.png Hematoma (flylib.com)].<ref>URL: [http://flylib.com/books/en/2.953.1.49/1/ http://flylib.com/books/en/2.953.1.49/1/]. Accessed on: 10 January 2011.</ref>


=Membranes=
=Membranes=
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==Amnion nodosum==
==Amnion nodosum==
===General===
{{Main|Amnion nodosum}}
*Associated with (long-standing) [[oligohydramnios]].<ref>URL: [http://library.med.utah.edu/WebPath/PLACHTML/PLAC042.html http://library.med.utah.edu/WebPath/PLACHTML/PLAC042.html]. Accessed on: 12 January 2011.</ref>
*Should be separated from ''squamous metaplasia of amnion''.
 
===Gross===
Features:<ref name=pmid18081444>{{Cite journal  | last1 = Adeniran | first1 = AJ. | last2 = Stanek | first2 = J. | title = Amnion nodosum revisited: clinicopathologic and placental correlations. | journal = Arch Pathol Lab Med | volume = 131 | issue = 12 | pages = 1829-33 | month = Dec | year = 2007 | doi = 10.1043/1543-2165(2007)131[1829:ANRCAP]2.0.CO;2 | PMID = 18081444 }}</ref>
*Yellow nodules ~ 1-5 mm.
**Some think they are white.<ref>CS. 7 February 2011.</ref>
 
DDx:
*[[Squamous metaplasia of the amnion]] - large irregular patches, usu. white.
 
Images:
*[http://www.webpathology.com/image.asp?n=2&Case=659 Amnion nodosum (webpathology.com)].
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-131-12-1829-f01&doi=10.1043%2F1543-2165%282007%29131%5B1829%3AANRCAP%5D2.0.CO%3B2 Amnion nodosum & squamous metaplasia of the amnion (archivesofpathology.org)].<ref name=pmid18081444/>
<!-- annoying use of '[' and ']' - had to go find escape characters here: http://www.w3schools.com/tags/ref_urlencode.asp -->
 
===Microscopic===
Features:<ref name=pmid18081444/>
*Stratified squamous epithelium - non-keratinizing ''or'' minimal keratin.
*Amorphous acidophilic (pink) debris.
 
Note:
*Normal amnion = simple epithelium.
 
Images:
*[http://www.webpathology.com/image.asp?case=659&n=3 Amnion nodosum (webpathology.com)].
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-131-12-1829-f01&doi=10.1043%2F1543-2165%282007%29131%5B1829%3AANRCAP%5D2.0.CO%3B2 Amnion nodosum & squamous metaplasia of the amnion (archivesofpathology.org)].<ref name=pmid18081444/>
<!-- annoying use of '[' and ']' - had to go find escape characters here: http://www.w3schools.com/tags/ref_urlencode.asp -->


==Placental meconium==
==Placental meconium==
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===Gross===
===Gross===
Features:<ref name=pmid18081444/>
Features:<ref name=pmid18081444>{{Cite journal  | last1 = Adeniran | first1 = AJ. | last2 = Stanek | first2 = J. | title = Amnion nodosum revisited: clinicopathologic and placental correlations. | journal = Arch Pathol Lab Med | volume = 131 | issue = 12 | pages = 1829-33 | month = Dec | year = 2007 | doi = 10.1043/1543-2165(2007)131[1829:ANRCAP]2.0.CO;2 | PMID = 18081444 }}</ref>
*White (or yellow) plaques - irregular outline.
*White (or yellow) plaques - irregular outline.


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==Acute villitis==
==Acute villitis==
===General===
{{main|Acute villitis}}
*Rare.
*Typically viral - see ''[[TORCH infections]]''.
 
===Microscopic===
Features:
*[[Neutrophil]]s in the villous stroma - '''key feature'''.
*+/-Features suggestive a particular infective etiology.
**Cytoplasmic inclusion +/-owl's eye nucleus ([[CMV]]).
 
====Images====
<gallery>
Image:CMV_placentitis2_mini.jpg | [[CMV]] placentitis. (WC)
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=1&Case=579 Acute villitis (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=579 Acute villitis (webpathology.com)].


==Villitis of unknown etiology==
==Villitis of unknown etiology==
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*May be spelled ''foetus papyraceus''.
*May be spelled ''foetus papyraceus''.
*[[AKA]] ''fetus compressus''.
*[[AKA]] ''fetus compressus''.
 
{{Main|Fetus papyraceus}}
===General===
*Remnant of a dead fetus usu. from a twin pregnancy.
**No clinical consequence for mother and remaining fetus.
 
Clinical:<ref name=Ref_Placenta141>{{Ref Placenta|141}}</ref>
*Documented multiple gestation by imaging.
*Elevated AFP.
*May be a "fetal reduction" in the context of ''in vitro'' fertilization (IVF).
 
Note:
*"Papyraceus" = paper-like.
 
===Gross===
*Pale yellow flattened disk or plaque with a pigmented macule<ref name=Ref_Placenta141>{{Ref Placenta|141}}</ref> - on membranes or placental disc.
 
===Microscopic===
Features:
*Fetal structures - such as:
**Cartilage.
**Bone.
 
Images:
*[http://www.nejm.org/doi/full/10.1056/NEJMicm020196 Fetus papyraceus (nejm.org)].
*[http://path.upmc.edu/cases/case128.html Fetus papyraceus (upmc.edu)].
*[http://www.neonet.ch/en/03_Case_of_the_month/archive/11_dermatologic_disorders/2002_10.asp Fetus papyraceus (neonet.ch)].<ref>URL: [http://www.neonet.ch/en/03_Case_of_the_month/archive/11_dermatologic_disorders/2002_10.asp http://www.neonet.ch/en/03_Case_of_the_month/archive/11_dermatologic_disorders/2002_10.asp]. Accessed on: 3 January 2012.</ref>


==Placental mesenchymal dysplasia==
==Placental mesenchymal dysplasia==
Michael
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