Umbilical cord vasculitis

From Libre Pathology
Jump to: navigation, search

Umbilical cord vasculitis is a relatively common occurance in placental pathology. It is thought to preceed funisitis and is closely related to chorioamnionitis.

General

  • Usually seen together with chorioamnionitis.
    • May be described as the fetal response to chorioamnionitis.[1]
  • Presence considered to be a good prognosticator.[1]

Microscopic

Features:

  • Neutrophils in the vessels of the umbilical cord.
  • Wharton's jelly without neutrophils.

Notes:

  • Margination of neutrophils in the affected vessels is usually seen, and (in theory) precedes the development of vasculitis.
  • Umbilical vein involvement (umbilical phlebitis) precedes umbilical artery involvement (umbilical arteritis).[2]

DDx:

  • Funisitis - neutrophils are also in the connective tissue of the umbilical cord (Wharton's jelly).

Grading

Umbilical cord vasculitis:[3]

  • +0.5 for each vessel.
  • +0.5 for each vessel with severe involvement.

Image

See also

References

  1. 1.0 1.1 Lahra, MM.; Jeffery, HE. (Jan 2004). "A fetal response to chorioamnionitis is associated with early survival after preterm birth.". Am J Obstet Gynecol 190 (1): 147-51. doi:10.1016/j.ajog.2003.07.012. PMID 14749651.
  2. Vedovato, S.; Zanardo, V. (Jun 2010). "[Chorioamnionitis and inflammatory disease in the premature newborn infant].". Minerva Pediatr 62 (3 Suppl 1): 155-6. PMID 21090086.
  3. Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 2311. ISBN 978-0781740517.