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By Colin L. Berry (auth.), Colin L. Berry MD, PhD, FRCPath (eds.)
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Extra info for Paediatric Pathology
Sample text
The material is best displayed for gross examination (a) by spreading it out on a flat surface. Usually a distinction can be made between blood clots (B) and decidual tissues (D). In some instances villi can be recognized grossly (V). The micrograph of an embedded blood clot (b) reveals villi among blood. (H and E; 40 x ) b 35 Mies J. Becker include pieces of blood clot for histological processing, since these may contain villi (Fig. 2b). Inspection of the fragmented material may also reveal membrane-like structures, some of which should always be examined histologically.
Concomitant with this mesenchymal differentiation, changes occur within the trophoblast. The layer of Langhans' cells gradually becomes inconspicuous (Fig. 1 Ob), a feature that correlates with decreased activity of budding villi. The cells flatten and become dispersed between those of the syncytiotrophoblast. The remaining cells are considered to represent inactive reserve cells that may b Fig. 9. 8 and b A placenta of approximately 26 weeks of gestation, showing a low-power view that still reveals the sprouting of newly formed villi from more centrally located, 'older' villi (8) and a detail of one ofthese newly formed villi (b).
H and E; 350 x ) Mies J. Becker important to note that classic intervillous thrombosis (see below) does not occur as a post-mortem change; when observed it is always an indication of a pre-existing abnormality. Fibrin deposition, on the other hand, does occur and indeed can become so extensive that vast areas of fibrous villi may become completely encased within fibrin (Fig. 19). On gross examination such placentas are firm and greyish-white on their cut surface. It is in this final stage, which occurs after some months, that a precise interpretation of the abnormalities is no longer feasible.