Difference between revisions of "Fetal thrombotic vasculopathy"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Fetal_thrombotic_vasculopathy_-_intermed_mag.jpg | |||
| Width = | |||
| Caption = Fetal thrombotic vasculopathy. [[H&E stain]]. | |||
| Synonyms = fibrinous vasculosis, fibromuscular sclerosis, fetal artery stem thrombosis | |||
| Micro = thrombus in the fetal vasculature +/- recanalization (eosinophilic (light pink on H&E), moderately granular intravascular material (fibrin) with layering), +/-clustered fibrotic villi without blood vessels (chronic) | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[placenta]] | |||
| Assdx = fetal death, cerebral palsy | |||
| Syndromes = | |||
| Clinicalhx = +/-prothrombotic condition in mother | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = dependent on severity and underlying cause | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Fetal thrombotic vasculopathy''', abbreviated '''FTV''', is characterized by thrombi in the fetus. In the context of a [[placenta]], it is thrombi in the fetal [[blood vessel]]s of the placenta. | |||
A large number of terms are used for this including:<ref name=pmid19237859>{{Cite journal | last1 = Marchetti | first1 = D. | last2 = Belviso | first2 = M. | last3 = Fulcheri | first3 = E. | title = A case of stillbirth: the importance of placental investigation in medico-legal practice. | journal = Am J Forensic Med Pathol | volume = 30 | issue = 1 | pages = 64-8 | month = Mar | year = 2009 | doi = 10.1097/PAF.0b013e318187387e | PMID = 19237859 }}</ref> '''fibrinous vasculosis''', '''fibromuscular sclerosis''' and '''fetal artery stem thrombosis'''. | |||
The multitude of terms reflects the confusion about this finding and that it has numerous etiologies.<ref name=pmid19237859/> | |||
==General== | |||
*May cause [[IUGR]]. | |||
*Associated with cerebral palsy and common in perinatal deaths.<ref name=pmid10414494>{{Cite journal | last1 = Kraus | first1 = FT. | last2 = Acheen | first2 = VI. | title = Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy. | journal = Hum Pathol | volume = 30 | issue = 7 | pages = 759-69 | month = Jul | year = 1999 | doi = | PMID = 10414494 }}</ref> | |||
*Mother may have a prothrombotic condition.<ref name=pmid24108664>{{Cite journal | last1 = Magnetti | first1 = F. | last2 = Bagna | first2 = R. | last3 = Botta | first3 = G. | last4 = Viano | first4 = A. | last5 = Dorati | first5 = G. | last6 = Raia | first6 = M. | last7 = Bertino | first7 = E. | last8 = Saracco | first8 = P. | title = Fetal Thrombotic Vasculopathy and Perinatal Thrombosis: Should all Placentas be Examined? | journal = Am J Perinatol | volume = | issue = | pages = | month = Oct | year = 2013 | doi = 10.1055/s-0033-1357267 | PMID = 24108664 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=pmid10414494>{{Cite journal | last1 = Kraus | first1 = FT. | last2 = Acheen | first2 = VI. | title = Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy. | journal = Hum Pathol | volume = 30 | issue = 7 | pages = 759-69 | month = Jul | year = 1999 | doi = | PMID = 10414494 }}</ref> | |||
*Thrombus in the fetal vasculature +/- recanalization. | |||
**Eosinophilic (light pink on H&E), moderately granular intravascular material (fibrin) with layering. | |||
*Clustered fibrotic villi without blood vessels - '''key feature'''. | |||
**This is a chronic change. | |||
===Images=== | |||
Case 1: | |||
<gallery> | |||
Image: Fetal thrombotic vasculopathy - low mag.jpg | FTV - low mag. (WC) | |||
Image: Fetal thrombotic vasculopathy - intermed mag.jpg | FTV - intermed. mag. (WC) | |||
Image: Fetal thrombotic vasculopathy - high mag.jpg | FTV - high mag. (WC) | |||
Image: Fetal thrombotic vasculopathy - very high mag.jpg | FTV - very high mag. (WC) | |||
</gallery> | |||
Case 2: | |||
<gallery> | |||
Image: Fetal thrombotic vasculopathy -- low mag.jpg | FTV - low mag. (WC) | |||
Image: Fetal thrombotic vasculopathy -- intermed mag.jpg | FTV - intermed mag. (WC) | |||
Image: Fetal thrombotic vasculopathy - alt -- intermed mag.jpg | FTV - intermed mag. (WC) | |||
Image: Fetal thrombotic vasculopathy -- high mag.jpg | FTV - high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://jcp.bmj.com/content/61/12/1254/F8.large.jpg FTV (bmj.com)].<ref>URL: [http://jcp.bmj.com/content/61/12/1254.abstract http://jcp.bmj.com/content/61/12/1254.abstract]. Accessed on: 12 January 2011.</ref> | |||
*[http://gut.bmj.com/content/41/3/354/F3.large.jpg Thrombus - rat (bmj.com)].<ref>URL: [http://gut.bmj.com/content/41/3/354.full http://gut.bmj.com/content/41/3/354.full]. Accessed on: 12 January 2011.</ref> | |||
*[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4a.jpg FTV - low mag. (womenandinfants.org)].<ref>URL: [http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm]. Accessed on: 17 December 2012.</ref> | |||
*[http://www.womenandinfants.org/fertilityandpregnancy/images/FTV.Fig.4b.jpg FTV - high mag. (womenandinfants.org)]. | |||
==Sign out== | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | |||
- FETAL THROMBOTIC VASCULOPATHY, SEE COMMENT. | |||
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI INCREASED PERIVILLOUS FIBRIN DEPOSITION | |||
AND CALCIFICATIONS. | |||
- PLACENTAL INFARCT (1.5 CM IN MAXIMAL DIMENSION). | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
- FETAL MEMBRANES WITHIN NORMAL LIMITS. | |||
COMMENT: | |||
Mother and baby should be worked up for prothrombotic conditions. | |||
</pre> | |||
==See also== | |||
*[[Placenta]]. | |||
*[[Systemic lupus erythematosus]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Placenta]] | |||
Latest revision as of 22:35, 14 November 2016
| Fetal thrombotic vasculopathy | |
|---|---|
| Diagnosis in short | |
 Fetal thrombotic vasculopathy. H&E stain. | |
|
| |
| Synonyms | fibrinous vasculosis, fibromuscular sclerosis, fetal artery stem thrombosis |
|
| |
| LM | thrombus in the fetal vasculature +/- recanalization (eosinophilic (light pink on H&E), moderately granular intravascular material (fibrin) with layering), +/-clustered fibrotic villi without blood vessels (chronic) |
| Site | placenta |
|
| |
| Associated Dx | fetal death, cerebral palsy |
| Clinical history | +/-prothrombotic condition in mother |
| Prognosis | dependent on severity and underlying cause |
Fetal thrombotic vasculopathy, abbreviated FTV, is characterized by thrombi in the fetus. In the context of a placenta, it is thrombi in the fetal blood vessels of the placenta.
A large number of terms are used for this including:[1] fibrinous vasculosis, fibromuscular sclerosis and fetal artery stem thrombosis.
The multitude of terms reflects the confusion about this finding and that it has numerous etiologies.[1]
General
- May cause IUGR.
- Associated with cerebral palsy and common in perinatal deaths.[2]
- Mother may have a prothrombotic condition.[3]
Microscopic
Features:[2]
- Thrombus in the fetal vasculature +/- recanalization.
- Eosinophilic (light pink on H&E), moderately granular intravascular material (fibrin) with layering.
- Clustered fibrotic villi without blood vessels - key feature.
- This is a chronic change.
Images
Case 1:
FTV - low mag. (WC)
FTV - intermed. mag. (WC)
FTV - high mag. (WC)
FTV - very high mag. (WC)
Case 2:
FTV - low mag. (WC)
FTV - intermed mag. (WC)
FTV - intermed mag. (WC)
FTV - high mag. (WC)
www:
- FTV (bmj.com).[4]
- Thrombus - rat (bmj.com).[5]
- FTV - low mag. (womenandinfants.org).[6]
- FTV - high mag. (womenandinfants.org).
Sign out
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: - FETAL THROMBOTIC VASCULOPATHY, SEE COMMENT. - PLACENTAL DISC WITH THIRD TRIMESTER VILLI INCREASED PERIVILLOUS FIBRIN DEPOSITION AND CALCIFICATIONS. - PLACENTAL INFARCT (1.5 CM IN MAXIMAL DIMENSION). - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. - FETAL MEMBRANES WITHIN NORMAL LIMITS. COMMENT: Mother and baby should be worked up for prothrombotic conditions.
See also
References
- ↑ 1.0 1.1 Marchetti, D.; Belviso, M.; Fulcheri, E. (Mar 2009). "A case of stillbirth: the importance of placental investigation in medico-legal practice.". Am J Forensic Med Pathol 30 (1): 64-8. doi:10.1097/PAF.0b013e318187387e. PMID 19237859.
- ↑ 2.0 2.1 Kraus, FT.; Acheen, VI. (Jul 1999). "Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy.". Hum Pathol 30 (7): 759-69. PMID 10414494.
- ↑ Magnetti, F.; Bagna, R.; Botta, G.; Viano, A.; Dorati, G.; Raia, M.; Bertino, E.; Saracco, P. (Oct 2013). "Fetal Thrombotic Vasculopathy and Perinatal Thrombosis: Should all Placentas be Examined?". Am J Perinatol. doi:10.1055/s-0033-1357267. PMID 24108664.
- ↑ URL: http://jcp.bmj.com/content/61/12/1254.abstract. Accessed on: 12 January 2011.
- ↑ URL: http://gut.bmj.com/content/41/3/354.full. Accessed on: 12 January 2011.
- ↑ URL: http://www.womenandinfants.org/fertilityandpregnancy/current-topics-in-perinatal-pathology.cfm. Accessed on: 17 December 2012.