Ultrastructural changes of the placenta in cases of preeclampsia

The placenta plays vital roles during fetal development and growth. The ultrastructure of the placenta together with remodeling of the uterine spiral arteries are very important to maintain the utero-placental blood flow. Preeclampsia (PE) is a multifactorial disorder with abnormal placentation affecting the mother and fetus. The aim of this study was to study the ultrastructural abnormalities of the placenta in cases of PE. The placentas of 10 PE women and 10 controls were studied. Women of PE group were delivered by caesarian section while seven control women were delivered vaginally, and three by caesarian section. Placental samples were studied both morphologically and histologically by light and transmission electron microscopy. Light microscopic study of control placentas showed numerous microvilli, few syncytial knots, thin-walled blood vessels. PE placentas showed reduced number of microvilli with numerous syncytial knots, thick-walled vessels, edematous spaces, fibrotic areas and fibrinoid degeneration. Electron microscopic study of the control placentas showed a thick layer of syncytiotrophoblast (Sy), numerous microvilli and a thin layer of cytotrophoblast (Cy). PE placenta showed hypertrophy of Cy with atrophy of Sy and scarce microvilli. The trophoblast showed edematous vacuoles and glycogen storage areas. The villous core had congested capillaries, edematous spaces, glycogen storage areas and widespread areas of fibrosis. All the changes in PE placentas were attributed to hypoxia and oxidative stress and reduced utero-placental flow due to abnormal remodeling of the uterine spiral arteries that was aggravated by the thick placental barrier and the presence of edema, fibrosis and glycogen storage areas.

Listeria monocytogenes meningoencephalomyelitis most likely due to septic spread as a rare cause of neurological disease and fever in an adult horse

A 14-year-old warmblood mare developed progressive neurological signs including ataxia, nystagmus, impaired mental status as well as decreased cranial nerve reflexes, and finally went recumbent. Postmortem examination and histology revealed severe chronic active multifocal suppurative meningoencephalomyelitis with multifocal fibrinoid degeneration and necrosis of the vessel walls, multiple microabscesses and pyogranulomas. Additionally, there was mild multifocal necrotising to pyogranulomatous hepatitis and moderate multifocal suppurative to pyogranulomatous interstitial nephritis with fibrinoid degeneration of the vessel walls. Routine diagnostic procedures did not reveal any viral or bacterial aetiology; however, listerial enrichment with subsequent matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) analysis and 16S rRNA sequencing confirmed infection with Listeria monocytogenes. Listeriosis is uncommonly reported as a cause of sepsis in foals and rarely in adult horses. Furthermore it is rarely reported causing meningoencephalitis in foals as well as in adult horses. To the authors’ knowledge, this is the first case of meningoencephalomyelitis most likely due to septic distribution in an adult horse.

Clinical correlation with pathology of placenta in medical disorders of pregnancy and its comparison in normal pregnancy

Background: Healthy placenta is responsible for maintaining pregnancy and promoting normal foetal development. It reflects the intrauterine status of the foetus.Methods: In the present prospective study, total 50 Placentae from Medical Disorders of Pregnancies were studied and compared with equal number of Placentae from normal Pregnancies.Results: The significant macroscopic changes were calcification and infarction seen in Hypertensive Disorder. Extensive placental infarction was associated with high incidence of low APGAR (82%) and perinatal deaths (66.67%). No significant gross macroscopic changes were seen in Anaemia, Diabetes Mellitus and Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity were significant microscopic changes in Hypertensive Disorder. In Anaemia stromal fibrosis, increased syncytial knots were seen, whereas in Diabetes Mellitus villous edema was the most significant microscopic finding. No significant microscopic change was found in Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity, stromal fibrosis were associated with increased perinatal mortality.Conclusions: Gross and microscopic examination of placenta is strongly recommended in cases where maternal co-morbid conditions is likely to have an adverse perinatal outcome.

Eosinophilic Fasciitis Associated with Myositis

Eosinophilic fasciitis is clinically characterized by symmetrical scleroderma-like indurations of the skin with pain. The histological features are fascial inflammation with lymphocytes and eosinophils as well as thickened and fibrotic fascia. Lymphocytic infiltration and degeneration of the underlying muscle are rarely observed. We report a 69-year-old Japanese woman who presented with multiple areas of glossy induration and painful peau d'orange-like lesions on the chest and four extremities. T2-weighted magnetic resonance imaging showed significant hyperintense thickening of the fascia of the lower extremities. Histopathological examination of a biopsy specimen from the induration showed marked fibrinoid degeneration of the fascia and the neighboring muscle with mixed cellular infiltration of lymphocytes and eosinophils. The predominant CD8+ lymphocytic infiltrates were observed by immunohistological study. A diagnosis of eosinophilic fasciitis with myositis was made. Oral administration of prednisolone and discontinuation of exercise significantly improved the lesions and pain.

Localized Amyloid Deposition in Trigger Finger

Trigger finger is due to degeneration and thickening of the proximal portion (A1 pulley) of the flexor tendon sheath, which causes constriction of the flexor tendon. This study reports the presence of localized amyloid deposition in the tendon sheath of 11 of 47 cases (23%) of idiopathic primary trigger finger. Amyloid deposits were only found in patients aged over 46 years old and were present around cells and at sites of mucinous and fibrinoid degeneration which contained highly sulphated glycosaminoglycans. The pathogenic significance of these deposits is uncertain but their small size and presence only in middle-aged and elderly adults suggests that they represent a form of age-associated amyloid deposition.

Altered Collagen (Fibrinoid Change) at the Site of Post-Mortem Injuries

The terms fibrinoid degeneration and fibrinoid substance were first introduced by Neumann in 1880 to describe some alterations in the staining characteristics of collagen. Collagen fibres which have undergone this change are eosinophilic, homogeneous and take some of the tinctorial properties of fibrin. Lendrum et al. (1962) developed Martius-Scarlet-Blue (MSB) stain, which is preferentially taken up by fibrin. The principle of the method described by Lendrum and his colleagues is the use of acid dyes of different molecular size (Martius yellow, Brilliant Crystal Scarlet 6R, methyl blue) in accordance with the alteration in structure of fibrin at different stages of development. The newest fibrin likely to be found in sections is presumably the fine network of post-mortem fibrin. Much of this takes a yellow stain with the MSB method, as do erythrocytes. Slightly older fibrin (16 hours) takes a bright red stain with the MSB. Complete validity of the method depends on prolonged fixation in formal-sublimate. It gives brilliant staining with acid dyes and enhances metachromasia. In the Department of Forensic Medicine in Leeds it was noticed that an alteration in collagen staining with MSB stain was taking place in samples collected from different kinds of injuries, e.g. ligature marks, electrical injuries and burns. Similar changes were only occasionally seen in abrasions. It was therefore decided to inflict different kinds of injuries on the skins of rats and to fresh pieces of human skin in vitro, to observe any alterations in collagen staining with MSB and to assess the significance of these changes in relation to the timing of injuries. The experimental findings are presented, along with discussion and a review of the literature.

Pathology of Aujeszky's Disease in Mink

Lesions in 21 mink which died of Aujeszky's disease included hemorrhages in lungs, heart, mediastinum, thymus, diaphragm, gastric wall, pancreas, and enteric wall. Microscopically, hyalin and fibrinoid degeneration and necrosis of vessel walls were present in cardiac muscle, brain, gastrointestinal wall and occasionally elsewhere in the body. Hemorrhages, exudation of plasma proteins and necrosis were associated with the angiopathy. Inflammation was minimal or absent. Other findings were congestion and extravasation of blood (lungs, liver), necrosis of lymphoid cells, and hemoglobinuric nephrosis. Aujeszky's disease virus was isolated from all but three animals. After experimental infection of three mink, similar though less pronounced lesions were found to those observed in the field cases.