Funisitis Associated with Leptospiral Abortion in an Equine Placenta

Funisitis, inflammation of the umbilical cord, is well recognized in human placentas. This report describes a case of funisitis associated with leptospiral infection in the placenta of a Thoroughbred foal born prematurely. The umbilical cord had diffuse superficial yellow discoloration along its entire length. Microscopic evaluation showed an exudate of neutrophils admixed with fibrin on the surface. Warthin-Starry staining showed spirochetes in the Wharton's jelly of the umbilical cord. A locally extensive, severe placentitis not involving the star and allantoic cystic hyperplasia were the other lesions observed in the allantochorion. Leptospira funisitis is similar to the funisitis of congenital syphilis in humans, although there are some major microscopic differences. in Leptospira funisitis, lesions were limited to the cord surface, whereas in lesions in human umbilical cords with Treponema pallidum infection, the changes are observed mostly around the vessels and in the Wharton's jelly.

The binucleate cell of okapi and giraffe placenta shows distinctive glycosylation compared with other ruminants: a lectin histochemical study

The placenta of ruminants contains characteristic binucleate cells (BNC) with a highly conserved glycan structure which evolved early in Ruminant phylogenesis. Giraffe and Okapi placentae also contain these cells and it is not known whether they have a similar glycan array. We have used lectin histochemistry to examine the glycosylation of these cells in these species and compare them with bovine BNC which have a typical ruminant glycan composition. Two placentae, mid and near term, from Giraffe (Giraffa camelopardalis) and two term placenta of Okapi (Okapia johnstoni) were embedded in resin and stained with a panel of 23 lectins and compared with near-term bovine (Bos taurus) placenta. Significant differences were found in the glycans of Giraffe and Okapi BNC compared with those from the bovine, with little or no expression of terminal αN-acetylgalactosamine bound by Dolichos biflorus and Vicia villosa agglutinins which instead bound to placental blood vessels. Higher levels of N-acetylglucosamine bound by Lycopersicon esculentum and Phytolacca americana agglutinins were also apparent. Some differences between Okapi and Giraffe were evident. Most N-linked glycans were similarly expressed in all three species as were fucosyl residues. Interplacentomal areas in Giraffe and Bovine showed differences from the placentomal cells though no intercotyledonary BNC were apparent in Okapi. In conclusion, Giraffidae BNC developed different glycan biosynthetic pathways following their split from the Bovidae with further differences evolving as Okapi and Giraffe diverged from each other, affecting both inter and placentomal BNC which may have different functions during development.

Associations of intrauterine growth restriction with placental pathological factors, maternal factors and fetal factors; clinicopathological findings of 257 Japanese cases

Intrauterine growth restriction (IUGR) is the leading cause of fetal mortality and morbidity. As an etiology, each of placental findings, maternal factors and fetal factors has been reported to be associated with IUGR, although a comprehensive approach to examine all of these parameters as a cause of IUGR has not been reported. In the present study, therefore, we comprehensively examined the placental findings and maternal and fetal factors in the cases of IUGR (n=257, mean maternal age, 30 years; gestational weeks, 34 weeks) and normal growth pregnancies (n=258, mean maternal age, 30 years; gestational weeks, 33 weeks), and determined risk factors for IUGR. The prevalence of pregnancy hypertension (PHT) (19% vs. 8%, P<0.01), smoking habit (3% vs. 0.7%, P<0.05) and fetal anomaly (3.5% vs. 0.8%, P<0.05) were higher in IUGR cases than normal growth pregnancies. Pathologically, the prevalence of infarction (33% vs. 14%, P<0.05), fetal vessel thrombosis (22% vs. 6%, P<0.001) and chronic villitis (11% vs. 3%, P<0.001) were higher in IUGR cases than those in normal growth pregnancies. A multivariable regression analysis revealed that maternal factors (PHT), fetal factors (anomaly), and placental findings (infarction, fetal vessel thrombosis, and chronic villitis) are independently associated with increased risk of IUGR (all P<0.01).

Marrow Chimerism in Marmosets

In the femoral marrow of three adult marmosets, two male Callithrix jacchus and one female Leontocebus rosalia, a number of opposite-sexed metaphases were found. It is inferred that this chimeric state resulted from intrauterine placental anastomoses between heterosexual twins. The lack of the freemartin effect in connection with this chimerism is discussed, and the structural nature of the Y chromosome in the Callithricidae is described.

Residual vascular communications in twin-twin transfusion syndrome treated with sequential laser surgery: frequency and clinical implications

OBJECTIVES

The goal of fetoscopic laser surgery for twin-twin transfusion syndrome (TTTS) is to ablate all placental vascular communications, thereby separating the fetal circulatory systems. We sought to ascertain the frequency and clinical implications of residual vascular communications (RVC) post preferential sequential selective laser photocoagulation of communicating vessels (SQLPCV).

STUDY DESIGN

TTTS placentas treated via preferential SQLPCV were examined. Patency of vascular communications was assessed via water and/or milk injections. Cases with intrauterine fetal demise or placental disruption were excluded. Outcomes with and without RVC were compared.

RESULTS

One hundred seventy-four TTTS patients were treated during the study period. Dual survival at birth was 76% (133/174). Of the 133 dual survivors, 105 (79%) submitted an intact placenta. Five of these 105 placentas had RVC (4.8%). Comparison of RVC versus non-RVC cases revealed the following: gestational age at delivery 28.7(6.5) vs. 33.4(3.3) weeks (p=0.178); recipient birth weight 1287(1061) vs. 1973(610) grams (p=0.020); donor birth weight 1429(1369) vs. 1653(715) grams (p=0.518); donor central/eccentric placental cord insertion 80% vs. 17% (p=0.006). One case required a second laser surgery to complete the laser ablation; this placenta did not have RVC after delivery. Otherwise there were no cases of persistent TTTS. One of the 5 RVC cases (20%) exhibited neonatal findings consistent with twin anemia-polycythemia sequence (TAPS), while none of the non-RVC cases had TAPS (p=0.005).

CONCLUSIONS

The rate of RVC was less than 5% among gestations with dual survivors post preferential SQLPCV treatment for TTTS.

Placental tumor from an East African bongo (Eurycerus isaaci) fetus

This case report describes a placental tumor from a stillborn East African bongo fetus. On gross examination, the tumor was reminiscent of a chorangioma; however, based on histomorphology, histochemical and immunophenotypic characterization, comparison to 21 human cases of chorangioma, and embryogenesis, this tumor is hypothesized to be a placental stem cell tumor. Histologically, the tumor had 2, often commingled, morphologies with one area having dense cellularity and scant vascularity and a second area having scant cellularity and prominent vascularity. Pleomorphic mesenchymal cells were arranged in intersecting fascicles, often whorled around, or were contiguous with vascular channels and had features of skeletal muscle, smooth muscle, pericyte, endothelial, fibrous, and undifferentiated mesenchymal cells. Phosphotungstic acid-hematoxylin outlined cross-striations in some cells. Cells variably were immunoreactive for vimentin, CD31, von Willebrand factor VIII, desmin, muscle specific actin, alpha-smooth muscle actin, and skeletal myosin and negative for cytokeratin antigens. The relationship of this tumor to the presence of fetal musculoskeletal and omental anomalies is discussed.

Umbilical Arterial Thrombosis with Vascular Wall Necrosis: Clinicopathologic Findings of 11 Cases

Thrombosis of umbilical cord vessels is associated with a high perinatal mortality. Most cases are venous thrombi, arterial thrombi are uncommon. To clarify clinical and pathological features of this entity, we reviewed 11 cases with umbilical artery thrombosis. The gestational ages were 33-40 (mean 36.8) weeks. Three cases (38%) were associated with severe intrauterine growth retardation and two cases (25%) led to intrauterine fetal deaths. All cases had completely occlusive thrombi of one umbilical artery. The arteries with thrombosis demonstrated partial necrosis of vascular wall. The pathogenesis is unclear, but nine cases (82%) had cord abnormalities (long cord, peripheral cord insertion, short cord with twist, funisitis). This paper is the first report of clinical and pathological features of umbilical artery thrombosis. The results of this study confirm the clinical importance and unique histological findings of umbilical artery thrombosis. The recognition of umbilical artery thrombosis is necessary to establish the diagnosis and treatment of this condition.

Effect of porcine zonae pellucidae immunisation on ovarian follicular development and endocrine function in domestic ewes (Ovis aries)

Domestic ewes (Ovis aries) were immunised with porcine zonae pellucidae (pZP) or pZP conjugated to keyhole limpet haemocyanin (KLH) in adjuvant(s) to examine the feasibility of the species to serve as a model for further development of pZP-based vaccines in ungulates. Two immunisation groups were employed, with a third group receiving only adjuvant (n = 5 per group). Early in the study, oestrous activity was monitored by the use of a vasectomised ram fitted with a marking harness. Eventually, ewes were exposed to an intact ram for breeding. In addition, weekly serum and every-other-day faecal samples were collected to measure pZP antibodies and progesterone metabolite concentrations respectively. At the conclusion of the study, fecundity was established, and ovarian tissue was examined. Ewes immunised against pZP : KLH with adjuvant produced minimal antibody absorbance levels, displayed normal oestrous cycles, became pregnant upon introduction of the intact ram and exhibited normal ovarian histopathology. Ewes immunised against pZP with adjuvant produced high antibody absorbance levels, were acyclic following primary immunisation and were infertile. Examination of the ovarian tissue revealed atrophic changes that included: (1) the absence of growing follicles; (2) significant reduction in the number of primordial follicles; and (3) the presence of abnormal granulosa cell clusters lacking oocytes. Antisera displayed immunoreactivity to the major components of pZP, and immunohistochemical labelling of ovarian tissue showed specificity to the ZP. These data are the first generated in an ungulate species showing deleterious effects of pZP immunisation on folliculogenesis and oestrous cyclicity.

Ovarian choriocarcinoma in a rhesus monkey associated with elevated serum chorionic gonadotropin levels

A clinically normal, 3-year-old female rhesus monkey (Macaca mulatta), which was part of a routine toxicology study, had a mass in the right ovary with metastases to the adjacent mesentery and lungs. The histologic features and immunohistochemistry results were consistent with the diagnosis of choriocarcinoma. Neoplastic cell types included cytotrophoblast (positive for cytokeratin), syncytiotrophoblast (positive for human chorionic gonadotropin), and extravillous trophoblast (positive for human placental lactogen). Because the neoplasm was present in the ovary, the uterus was normal, and the animal was not currently pregnant, this was considered a primary ovarian neoplasm of germ cell origin. The monkey had elevated serum levels of chorionic gonadotropin at the beginning of the study, indicating that, as in women, choriocarcinomas in monkeys can be associated with increased gonadotropin levels and that the tumor was preexisting at the start of the toxicology study.

Equine placental teratoma

The placenta from a 300-day-gestational age, female, Arabian equine fetus was examined. Multifocal to coalescing, 0.5- to 4-cm-diameter, white, smooth nodules covered 50% of the placenta. Microscopic evaluation of the nodules revealed undifferentiated germ cells and a haphazard arrangement of immature, mesenchymal stroma, cartilage, squamous cornifying epithelium, scattered ducts and secretory acini lined by cuboidal to columnar epithelium, and mineralized foci. No umbilicus, arrangement about an axial skeleton, or organized polarity of structures was present. The lesion was diagnosed as a placental teratoma, a lesion not reported in species other than man.

Trisomy 17 in a bonobo (Pan paniscus) and deletion of 3q in a lowland gorilla (Gorilla gorilla gorilla): comparison with human trisomy 18 and human deletion 4q syndrome

A female bonobo (Pan paniscus) born at the San Diego Zoo exhibited inability to nurse and progressive weakness plus multiple congenital abnormalities including aural canal atresia and stenosis, malformed auricles, clenched hands, lordosis, agenesis of the caudal vertebra and cardiac abnormalities. Chromosome analysis identified the bonobo as being trisomic for chromosome 17, the homolog of human chromosome 18. Genotyping with human microsatellites suggested the extra chromosome was maternal in origin. In addition, a male lowland gorilla (Gorilla gorilla gorilla), also born at the zoo, exhibited postnatal growth retardation, facial dysmorphisms and small hands with short fingers. Karyotype analysis revealed the gorilla carried a deletion of the distal q arm of chromosome 3, the homolog of human chromosome 4. The phenotypic and karyotypic abnormalities found in the bonobo and gorilla were consistent with the characteristics of human trisomy 18 and human deletion 4q syndrome, respectively.

The placenta in multiple pregnancy: outstanding issues

The present paper reviews the placental development in multiple gestations and highlights the twin-to-twin transfusion syndrome, its recognition and possible therapy, and some of the consequences of fetal death of one twin. It presents data on discordance for structural anomalies in monozygotic twins. These aspects are discussed with respect to their possible pathogenetic origins.

Comparative cytogenetics of the African elephant (Loxodonta africana) and Asiatic elephant (Elephas maximus)

G- and C-banded karyotypes of the two extant species of the mammalian order Proboscidea are presented for the first time. Chromosome complements were 2n = 56 in both Loxodonta africana and Elephas maximus. Comparisons between the species demonstrated a high level of chromosome band homology, with 26 conserved autosomal pairs. The normal diploid karyotype of L. africana had 25 acrocentric/telocentric and two metacentric/submetacentric autosomal pairs. E. maximus differed by having one less acrocentric and one additional submetacentric pair due to either a heterochromatic arm addition or deletion involving autosomal pair 27. Several acrocentric autosomes of L. africana exhibited small short arms that were absent in homologous chromosomes of E. maximus. The X chromosomes in both species were large submetacentric elements and were homologous. However, the small acrocentric Y chromosomes differed; in E. maximus it was slightly larger and had more distinct G-bands than its counterpart in L. africana. Extant Elephantidae appear to be relatively conservative in their rates of chromosomal change compared to some other mammalian families. The high-quality banded karyotypes presented here should prove useful as references in future chromosome analyses of elephant populations and in comparative cytogenetic studies with other ungulate orders.

Exposure to the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) induces squamous metaplasia in the endocervix of cynomolgus macaques

Female cynomolgus macaques (n = 11) were treated orally with graded doses of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Cervical tissue was recovered at necropsy 1.2-2.7 years later and examined using routine histopathology. Results were compared histologically with cervical tissue from untreated, age- and parity-matched controls. Significant squamous epithelial metaplasia was observed in the endocervix of 9 of 11 TCDD-treated animals, and the degree of severity was dose dependent. In contrast, minimal or no pathological changes were observed in eight of nine control animals and one animal had only mild squamous metaplasia. These results suggest that TCDD exposure induces epithelial transdifferentiation in the primate cervix. Consequently, the TCDD-treated macaque may serve as a predictable animal model for the study of cervical epithelial transdifferentiation and for examining the relationship between squamous metaplasia and cervical oncogenesis both at the cellular and at the molecular level.

Morbidity, mortality, and placental pathology in excessively long umbilical cords: retrospective study

The purpose of this study was to compare specific fetal, maternal, and placental factors, including neonatal morbidity and mortality, in infants with umbilical cords (UCs) of normal length to the same factors in infants with excessively long umbilical cords (ELUCs). We performed an 18-year retrospective chart review of the medical records of mothers and infants with ELUCs (926 cases) and normal-length UCs (200 cases) and recorded maternal factors, fetal factors, and neonatal outcomes. Corresponding placental pathologic reports and slides were reviewed. Statistical analysis comparing the two groups included univariate and multivariate analyses. ELUCs were significantly associated with certain maternal factors (systemic diseases, delivery complications, increased maternal age), fetal factors (non-reassuring fetal status, respiratory distress, vertex presentation, cord entanglement, fetal anomalies, male sex, increased birth weight), gross placental features (increased placental weight, right-twisted cords, markedly twisted cords, true knots, congestion), and microscopic placental features (nucleated red blood cells, chorangiosis, vascular thrombi, vascular cushions, meconium, increased syncytial knots, single umbilical artery). Some of these histopathologic features have previously been associated with fetal hypoxia and/or altered blood flow in the placenta. Infants with ELUCs were found to be at a significantly increased risk of brain imaging abnormalities and/or abnormal neurological follow-up. In addition, mothers with a history of an ELUC are at increased risk of a second long cord.

Partial caudal duplication in a newborn associated with meningomyelocele and complex heart anomaly

BACKGROUND

Caudal duplication is a spectrum of rare congenital anomalies with a possible heterogeneous pathogenesis including incomplete separation of monovular twins.

METHODS

We report an autopsy case of a full-term infant with incomplete caudal duplication syndrome associated with multiple anomalies.

RESULTS

These anomalies included a duplicated penis; double urinary bladder with an attenuated tunica muscularis; duplication of lower bowel with two ilia, appendices and colons; colonic hypogangliosis and left imperforated anus associated with rectourethral fistula. Other anomalies consisted of sacral meningomyelocele, sacral duplication with hypoplastic left sacrum and pelvic bones, muscle atrophy and hypoplasia of the left lower extremity, abnormal lobation of liver with stomach entrapment, omphalocele, and right atrial isomerism syndrome. The complex pattern of anomalies suggests the possibility that partial caudal duplication might be part of the spectrum of conjoined twinning.

Diploid/triploid mosaic placenta with fetus. Towards A better understanding of 'partial moles'

We describe a case of partial molar change in a placenta that was associated with a normal female fetus who died in utero. The analysis of molar and normal placental tissue, as well as the karyotypic study of amnionic fluid indicate a complex origin of this conceptus. We review the possible mechanisms leading to this pregnancy and the general topic of partial hydatidiform mole. The formation of moles is complex and it is not easily divisible into so-called partial and complete hydatidiform moles. Rather, individual genetic study is needed to make an accurate diagnosis because macroscopic or microscopic examination alone fails to assess the complexity of these entities.

Chromosomal rearrangements in a Somali wild ass pedigree, Equus africanus somaliensis (Perissodactyla, Equidae)

Chromosome analyses were conducted on 15 animals in a pedigree of Somali wild ass, Equus africanus somaliensis. G- and C-banded karyotypes are presented for the first time on this endangered species. The diploid number ranged from 62 to 64. Numerical chromosomal variation was the result of a centric fission which was accompanied by a heterochromatic deletion. The fission polymorphism involved acrocentric elements 19 and 21 as determined by G-banding. These autosomes are homologous to those involved in centric fission/fusion polymorphisms in other equids: E. asinus (domestic donkey), E. hemionus (onager), E. kiang (kiang), and E. burchelli (common zebra). Banding analyses also revealed a paracentric inversion polymorphism in submetacentric chromosome pair 2 of E. a. somaliensis. Both the centric fission and paracentric inversion polymorphisms involved heterochromatic regions. One individual was found to be heterozygous for two de novo chromosomal rearrangements: a centric fission (involving acrocentric elements 19 and 21) and a heterochromatic deletion of chromosome 2.

Remarkable placenta

This paper reviews the principle features of human placenta structure and development, and it highlights areas of needed future research. The complexity of placental histology is discussed and comparison of the human placenta with other mammalian taxa is made. A more widespread appreciation of the value of studying this challenging organ and a more profound understanding of the regulation of the placental transport functions is advocated. Simple, routine examination of the placenta should be resurrected.

Fetal obstructive uropathy: patterns of renal pathology

Fetal obstructive uropathy (FOU) is characterized by obstruction of the urethra, renal anomalies, ureterovesical dilatation, oligohydramnios, cryptorchidism, and abdominal muscle wall changes. The main objective of the present study was to better understand the relationship between FOU and renal pathology using a series of 15 male autopsy cases. A total of 11 cases with patent anus and 4 with imperforate anus were analyzed. Of the first group, most cases showed obstruction at the level of prostatic urethra. Seven cases showed obstruction at the level of the prostatic urethra and histologic study revealed scarring and partial or complete absence of the prostate, while in the remaining four cases the prostate was present. Of the cases with imperforate anus, two showed obstruction at the level of prostatic urethra, one showed posterior urethral valves, and one was obstructed at the proximal urethra. In all cases the kidneys showed mixed (dysplastic and cystic) changes with no significant differences between the two groups. An inverse correlation was observed between degree of renal dysplasia and gestational age, whereas the opposite was true for cystic changes. Distal and collecting tubules were more intensely immunoreactive to the anti-cytokeratin antibody when compared to proximal tubules. Moreover, anti-cytokeratin immunoreactivity was more prominent in tubules displaying cystic dilatation. DNA fragmentation analysis of renal tissue revealed a higher apoptosis of mesenchymal and tubular cells in the FOU cases, compared to gestational aged-matched controls. These results suggest that renal anomalies in FOU might be related to the gestational age at which the injury occurred and to the duration of the obstruction.

Partial molar transformation of the placenta of presumably monozygotic twins

A pregnancy with one normal female fetus and a placenta that was divided into halves, one normal the other molar, is described. Genetic analysis shows the molar component to be hyperdiploid/tetraploid but having an identical DNA composition as the normal twin. Because there was no trophoblastic proliferation and the hyperdiploid cells were confined to the villous stroma, and because the molar component was still being perfused by diploid vessels from the normal twin, we believe the mole is derived from polyploidization of the mesenchymal epiblast in a monozygotic twin pregnancy.

Placental pathology casebook. Serpentine aneurysms of the placenta with fetal consequences

Two cases of placental surface vessel aneurysms are presented. One case was associated with severe fetal intrauterine growth restriction and fetal thrombocytopenia. The other case was associated with "molar transformation" of placental villous tissue.

Elephant dental pulp tissue: where are the nerves?

Dental pulp tissue from three elephants was examined histologically with hematoxylin and eosin and s-100 protein stains. In all specimens, normal pulp was found with the exception that no nerve fibers (myelinated or non-myelinated) were demonstrable in any of the numerous sections prepared.

Reliability of placental histology using archived specimens

Archived placental materials provide a resource for retrospective studies of perinatal outcomes. Using archived specimens, we evaluated inter-rater reliability in the assessment of placental histological features possibly associated with neonatal illness and long-term neurological outcome. Five expert placental pathologists independently reviewed archived placental specimens on 30 subjects born during 1983-85 in six different hospitals. Moderate to substantial agreement among the raters was observed for a variety of indicators of inflammation, presence of macrophages with pigment and indicators of villous maturity, increased syncytial knots and maternal vasculopathy. Existing pathology reports for these specimens from routine histology examinations conducted at the time of delivery were in substantial agreement with expert review for the presence of any subchorionitis/chorionitis/chorioamnionitis. In conclusion, considerable inter-rater agreement was observed for several relatively common and potentially important placental findings. Archived placental materials and pathology reports may be useful in retrospective studies.

Villitis of known origin: varicella and toxoplasma

Chronic villitis is a common condition in human placentae. In some cases an infectious cause can be demonstrated, such as infection with cytomegalovirus and rubella virus. Most often it is of unknown aetiology, the so-called VUE (villitis of unknown aetiology). We describe two cases with identification of specific infectious agents, each demonstrating previously unreported findings, i.e. persistent varicella antigen in the villi in case 1, and presence of toxoplasma cysts in Wharton's jelly in case 2. The identification of the pathogens, varicella virus and toxoplasma, would easily have been overlooked in routine study of the placenta and were possible because of clinical suspicion.

Recent trends in chorangiomas, especially those of multiple and recurrent chorangiomas

The nomenclature and occurrence of chorangioma of the placenta are reviewed here. Recurrence of multiple chorangiomas has been described, but it is apparently an uncommon or underreported event. There is a strong relationship between placental chorangiomas and gestation at high altitude, suggesting the occurrence of vascular growth factors induced by hypoxia. Fluid transitions may exist between chorangioma, chorangiomatosis, and chorangiosis, although the latter is common in diabetic pregnancies, whereas chorangiomas are not so correlated.