Placenta and POC Flashcards
Chorionic villi which are hydropic, with cistern formation, circumferential trophoblastic proliferation and atypia in trophoblastic cells. No fetal RBCs can be seen in capillaries.
Features of molar pregnancy favouring complete hydatidiform mole
Differential diagnosis:
Partial hydatidiform mole
Hydropic abortus
Plan:
Correlate with clinical history and radiology (?bHCG measurement ?USS findings ?evidence of fetal parts)
Correlate with any concurrent cytogenetic testing
IPX to support Dx: p57 (loss of staining in villous cytoplasmic and stromal cells)
Placental membrane roll with acute inflammation (neutrophils), +/- necrosis of amnion
Acute chorioamnionitis
Differential diagnosis:
Acute chorioamnionitis with meconium effect
Plan:
Correlate with clinical features and macroscopic features (?maternal / fetal sepsis ?prolonged rupture of membranes)
Correlate with concurrent microbiology investigations (e.g. placental swab) - if not done send fresh tissue urgently
Examine further sections (to formally stage and grade maternal and fetal inflammatory response)
Well circumscribed mass within placenta formed of fetal capillaries and surrounding stroma
Placental chorangioma
Plan:
Correlate with clinical history and radiology (?placental mass ?fetal monitoring/haemodynamic compromise)
Examine further blocks (e.g. for total size, areas of differing morphology)
IPX to support Dx: Not required
Advice to clinician: May be assiociated with infantile haemangiomas. Clinical correlation is required.