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Difference between revisions of "Villitis of unknown etiology"
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Villitis of unknown etiology (view source)
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Villitis_of_unknown_etiology_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Villitis of unknown etiology. [[H&E stain]]. | |||
| Micro = lymphocytes in the villous stroma, no neutrophils, no significant plasma cells | |||
| Subtypes = | |||
| LMDDx = [[acute villitis]] | |||
| Stains = | |||
| IHC = lymphocytes predominantly CD8 +ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[placenta]] | |||
| Assdx = [[IUGR]], recurrent pregnancy loss | |||
| Syndromes = | |||
| Clinicalhx = +/-previous pregnancy loss | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
'''Villitis of unknown etiology''', abbreviated '''VUE''', is rare recurrent pathology of the [[placenta]]. | |||
==General== | |||
Features:<ref name=pmid17889674>{{cite journal |author=Redline RW |title=Villitis of unknown etiology: noninfectious chronic villitis in the placenta |journal=Hum. Pathol. |volume=38 |issue=10 |pages=1439–46 |year=2007 |month=October |pmid=17889674 |doi=10.1016/j.humpath.2007.05.025 |url=}}</ref> | |||
*Usually term placenta. | |||
*Prevalence: 5% to 15% of all placentas. | |||
*Associated with: | |||
**[[Intrauterine growth restriction]] (IUGR). | |||
**Recurrent reproductive loss/adverse outcomes in subsequent pregnancies -- '''key point'''. | |||
***Recurrence in up 37% of cases.<ref name=pmid20604650>{{cite journal |author=Feeley L, Mooney EE |title=Villitis of unknown aetiology: correlation of recurrence with clinical outcome |journal=J Obstet Gynaecol |volume=30 |issue=5 |pages=476–9 |year=2010 |pmid=20604650 |doi=10.3109/01443611003802339 |url=}}</ref> | |||
Etiology: | |||
*Unknown - as the name of the entity suggests. | |||
**Suspected to be immune-mediated. | |||
==Microscopic== | |||
Features:<ref name=pmid17889674/> | |||
*Lymphocytes in villous stroma - '''key feature'''. | |||
**Usually focal/patchy. | |||
**Lymphocytes: maternal derivation, T-lymphocytes -- mostly CD8-positive. | |||
*+/-Intervillositis (lymphocytes between villi). | |||
*+/-Histiocytes. | |||
Notes: | |||
*Lymphocytes are smaller and stain darker than the cells of the villi. (???) | |||
*Neutrophils are usually absent. A significant number of 'em is suggestive of an infectious villitis. | |||
*Infective villitis is usu. B-cell predominant. | |||
*'''No''' plasma cells - this suggests an infectious etiology.<ref>Sherman, C. 7 February 2011.</ref> | |||
**Plasma cells may be seen in the decidua -- these can be ignored. | |||
===Images=== | |||
<gallery> | |||
Image:Villitis_of_unknown_etiology_-_intermed_mag.jpg | VUE - intermed. mag. (WC) | |||
Image:Villitis_of_unknown_etiology_-_very_high_mag.jpg | VUE - very high mag. (WC) | |||
</gallery> | |||
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://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> | |||
==See also== | |||
*[[Acute villitis]]. | |||
*[[TORCH infection]]. | |||
*[[Placenta]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Placenta]] | |||