GPR: 2020 - Week 51

From MGH Learn Pathology

Clinical history

30 F s/p SVD after IOL for PET with severe features. Fetal surface/chorionic plate of the placenta shows a 2.5 cm well-circumscribed fleshy mass with a red/tan cut surface:


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  • Usually nodular, fleshy lesions
  • Found on the fetal surface/chorionic plate
  • Frequently multiple, may be pedunculated (“berry-like”)
  • Variety of appearances depending on the size of the vessels, their congestion, the presence of infarction
  • Can be gelatinous, ill-defined, paler, irregularly lobated, firm/white when infarcted



Placental infarct

  • More solid and feel firmer than adjacent tissue
  • Appear granular due to the remaining villous "ghosts"
  • Over time color changes from red to white
  • Cystic and hemorrhagic changes may be seen
  • Older marginal infarcts are common, reflecting the poor perfusion near the edge of the placenta
  • Can be located anywhere (central vs peripheral) but are within the parenchyma and have linear defined margins



Intervillous thrombus

  • Palpable firm lesions
  • Shiny and more homogenous in texture than infarcts
  • The earliest thrombi are fresh red clots which progress to laminated red or white lesions to old white lesions.
  • Infarction may appear as a rim adjacent to intervillous thrombi which apparently interfere with local villous blood supply
  • Can be located anywhere (central vs peripheral) but are within the parenchyma



Subchorionic thrombus

  • Firm, white, discrete lesions beneath the fetal surface
Dr. Drucilla Roberts
  • Kaplan, C. G. (2007). Color Atlas of Gross Placental Pathology (Second ed.). New York, NY: Springer New York.
  • ExpertPath

This week's Gross Pathology Roundup was presented by Elisabeth Tabb, MD on Mon, Dec 14, 2020.