Eosinophilic/T-cell chorionic vasculitis

Pediatr Dev Pathol. 2002 Jul-Aug;5(4):350-5. doi: 10.1007/s10024-001-0128-9. Epub 2002 May 21.

Abstract

Chorionic vasculitis is the hallmark of a fetal response in chorioamnionitis. There are five highly characteristic findings: (1) leukocyte migration is not concentric but rather radiates toward the infected amniotic fluid; (2) the infiltrate is primarily neutrophils; (3) multiple chorionic vessels, first veins and then arteries, are usually involved; (4) the infiltrate never extends into the vasculature of stem villi; and (5) it is rare in the absence of chorioamnionitis (or its precursors). Here we describe a new form of chorionic vasculitis characterized by an infiltrate composed primarily of eosinophils and CD3+ T lymphocytes that very focally involves a single chorionic vessel (artery or vein), that radiates away from the amniotic fluid (i.e., toward the intervillous spaces), and that may extend into the stem villous vasculature; this lesion occurs in the absence of any evidence of chorioamnionitis. During the past 7+ years, using accepted placental review criteria, we have examined 7104 placentas and identified 14 cases of eosinophilic/T-cell chorionic vasculitis (or related lesions). Although the frequency of diagnosis in the placentas examined was 0.197%, its true incidence cannot be estimated because of its very focal nature and the limited nature of placental disk sampling. Its etiology and significance are unknown, but it may represent a focal immune-mediated vasculitis.

MeSH terms

  • Antigens, CD
  • Chorion / metabolism
  • Chorion / pathology*
  • Eosinophilia / metabolism
  • Eosinophilia / pathology
  • Eosinophils / metabolism
  • Eosinophils / pathology*
  • Female
  • Humans
  • Placenta Diseases / metabolism
  • Placenta Diseases / pathology
  • Pregnancy
  • Pregnancy Complications / metabolism
  • Pregnancy Complications / pathology
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / pathology*
  • Vasculitis / metabolism
  • Vasculitis / pathology*

Substances

  • Antigens, CD