Search Frames
Search No frames
PathWeb Home
©
Feed Back
About
Arterial Fibrinoid Necrosis in Placenta
Click on Image to Enlarge it
Arterial Fibrinoid Necrosis in Placenta

Low power view of the basal portion of the placenta.
The blue arrows point to the demarcation between the decidua containing the decidual arteries (yellow arrows) and the placenta.
Most of the placental architecture is obscured by extensive old hemorrhage; only a few villi are seen in the upper left (green arrow).
The decidual vessels (yellow arrows) have necrotic walls not readily appreciated at this power.
(Description By:Melinda Sanders,M.D. )
(Image Contrib. by:Melinda Sanders,M.D. UCHC )
Decidual Vasculopathy
Etiology

Unknown
Pathogenesis

Unknown
Blood vessels either fail to undergo normal physiologic conversion or develop pathologic changes following conversion,
Epidemiology

Associated with pregnancy induced hypertension
Associated with anticardiolipin antibodies and lupus anticoagulant
General Gross Description

Not grossly visible lesions in the blood vessels
Sequelae to decidual vasculopathy may be grossly evident as a small placenta (acceleration of villus maturation) or one displaying infarcts or abruption
General Microscopic Description

Unconverted vessels exhibit round cross section with a preserved muscularis and intima
Thrombosed vessels may exhibit mural or occlusive thrombosis with or without recanalization; thrombi may organize with smooth muscle proliferation
Lymphocytes or plasma cells may involve the wall of the vessel
Fibrinoid necrosis can be recognized as acellular, brilliantly eosinophilic and glassy transformation of the vessel wall
Atherosis, often accompanying fibrinoid necrosis, consists of an intramural accumulation of foamy macrophages resembling cells seen in atherosclerosis
These changes may occur in converted or unconverted vessels
Clinical Correlation

Severity of clinical disease does not correlate well with severity of pathology
Thrombosed vessels may result in villous infarct
Necrotic vessels may rupture with abruption
Unconverted vessels may respond to vasospasm and also lead to abruption
References

Benirschke K, Kaufmann P. Pathology of the Human Placenta, third edition, New York: Springer Verlag, 1995, pp. 484-500.
Decidual Vasculopathy
Synopsis by: Melinda Sanders M.D. (T4F190M54090)[421]
Search Medline at National Library of Medicine
Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window
Search Frames
Search No frames
PathWeb Home
©
Feed Back
About