Doss B J, Greene M F, Hill J, Heffner L J, Bieber F R, Genest D R
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Hum Pathol. 1995 Nov;26(11):1245-51. doi: 10.1016/0046-8177(95)90201-5.
Massive chronic intervillositis (MCI) is an unusual placental lesion associated with poor fetal growth and adverse pregnancy outcome; it has not previously been associated with spontaneous abortion or recurrent pregnancy loss. This article reports a patient who had 10 spontaneous abortions with repetitious massive chronic intervillositis documented in four of five gestations spanning all three trimesters. Characteristic placental histology induced massive infiltration of the maternal intervillous space by chronic inflammatory cells and fibrin, without associated chronic villitis; the cellular infiltrate was composed predominantly of LCA and CD68 immunoreactive cells with scattered CD45RO positivity, consistent with a monocyte/macrophage population with occasional T lymphocytes. Elevated maternal serum alpha-fetoprotein was documented in two pregnancies. These findings support the concept that this unusual placental lesion may have an immunologic basis, and suggest that MCI may be a histopathologically recognizable cause of recurrent spontaneous abortion.
重度慢性绒毛间隙炎（MCI）是一种罕见的胎盘病变，与胎儿生长受限及不良妊娠结局相关；此前尚未发现其与自然流产或复发性流产有关。本文报道了一名患者，该患者发生了10次自然流产，在涵盖所有三个孕期的五次妊娠中的四次妊娠中均记录到重复性重度慢性绒毛间隙炎。特征性胎盘组织学表现为慢性炎症细胞和纤维蛋白大量浸润母体绒毛间隙，无相关慢性绒毛炎；细胞浸润主要由LCA和CD68免疫反应性细胞组成，散在有CD45RO阳性，符合单核细胞/巨噬细胞群体，偶见T淋巴细胞。两次妊娠中均记录到母体血清甲胎蛋白升高。这些发现支持了这一不寻常的胎盘病变可能具有免疫基础的观点，并提示MCI可能是复发性自然流产的一种组织病理学上可识别的原因。
