CASE REPORT
Ruchika Gupta Æ Sonu Nigam Æ Prerna Arora
Nita Khurana Æ Swaraj Batra Æ Ashish Kumar Mandal
Clinico-pathological profile of 12 cases of chorangiosis
Received: 29 June 2005 / Accepted: 1 September 2005 / Published online: 6 October 2005
Ó Springer-Verlag 2005
Abstract Chorangiosis is one of the vascular lesions
that involvs terminal chorionic villi. It is commonly
associated with various feto-maternal conditions like
pre-eclampsia, diabetes etc. However, the clinical sig-
nificance of this pathological finding has not been
studied extensively. The aim of this study was to
identify the various conditions associated with
chorangiosis and to determine its clinical significance.
A retrospective study to identify the cases of placentas
diagnosed with chorangiosis was carried out and the
clinical and morphological details of these cases were
reviewed. Immunostaining for CD34 and muscle-spe-
cific actin was also performed to confirm chorangiosis
and to exclude chorangiomatosis.
A total of 12 cases of chorangiosis were retrieved, most
of them were of term gestation. Five of these 12 cases
were associated with various maternal conditions
including syphilis (2 cases) and single cases of pre-
eclampsia, diabetes and jaundice. One case in each had
abruptio placenta and non-immune hydrops. Of these
12 cases, seven were stillborn. Microscopically, all 12
cases showed extensive chorangiosis involving terminal
villi. In addition, two cases showed focal infarction and
one had extensive calcification. Immunostaining for
CD34 confirmed increased number of capillaries while
muscle-specific actin was negative, excluding chorangi-
omatosis.
The clinico-pathological profile presented in this study
suggests that chorangiosis has characteristic patholog-
ical features for its recognition and needs to be differ-
entiated from similar conditions like chorangioma and
chorangiomatosis. Also, chorangiosis has potential
clinical significance and should be mentioned in the
pathology report and the patient should be investigated
for associated conditions like syphilis, pre-eclampsia,
diabetes etc.
Keywords Chorangiosis Æ Syphilis Æ Pre-eclampsia Æ
Diabetes Æ Jaundice
Introduction
Chorangiosis (CH), one of the capillary lesions
involving placenta, has been defined as a process
involving terminal villi. The Altshuler criteria include
10 or more terminal villi having 10 or more capillaries,
in 10 or more fields of three or more random non-
infarcted placental areas using 10· microscopic objec-
tive (Altshuler 1984). Chorangiosis has been reported
in nearly 6–7% of placentas examined (Ogino and
Redline 2000). Various feto-maternal conditions
including pre-eclampsia, diabetes, cord anomalies are
associated with CH (Soma et al. 1996). However, there
are not many studies on the clinical significance of this
condition in literature, since most of the reports are
case reports.
This study was undertaken with an aim to study the
various associations with CH and to determine its clin-
ical significance. The differential diagnoses and clinical
significance have also been described.
P. Arora
Departments of Pathology, Maulana Azad Medical College
and associated Lok Nayak Hospital, New Delhi, India
R. Gupta
Departments of Pathology, Maulana Azad Medical College
and associated Lok Nayak Hospital, New Delhi, India
S. Nigam (&) Æ A. K. Mandal
Departments of Pathology, C - 367, Saraswati Vihar Pitampura,
New Delhi 110034, India
E-mail: snigam15@bol.net.in
N. Khurana
Departments of Pathology, Maulana Azad Medical College
and associated Lok Nayak Hospital, New Delhi, India
S. Batra
Departments of Gynaecology & Obstetrics,
Maulana Azad Medical College and associated
Lok Nayak Hospital,
New Delhi, India
Arch Gynecol Obstet (2006) 274: 50–53
DOI 10.1007/s00404-005-0076-0