Skip to main content

Advertisement

Log in

Angiogenesis in villous chorangiosis observed by ultrastructural studies

  • Original Paper
  • Published:
Medical Molecular Morphology Aims and scope Submit manuscript

Abstract

Chorangiosis is microscopically designated as more than ten terminal capillaries within the villous stroma of the placenta and is mostly related to chronic fetal hypoxia. However, the histogenetic relationship between increased number of terminal villous capillaries and chronic hypoxia has not yet been clarified. Of 665 placentas histologically examined at Saitama Medical University from 2003 to 2010, chorangiosis was found in 58 cases (8.7 %), which were mostly more than 35 gestational weeks. In addition, low birth weight (less than 2,500 g) infants (74.1 %) and those who suffered from cardiac anomalies, chromosome anomalies, and single umbilical artery comprised 32.7 % of cases. Placental lesions were associated with chorangiosis involved in infarct (46.6 %), intervillous thrombosis (20.7 %), and marginal hemorrhages (22.4 %). Scanning electron microscopic studies showed narrowing of vessel ostium and disorders of endothelium in the umbilical cord vessel complicated by chorangiosis. Furthermore, in transmission electron microscopic observation, not only the chorionic villi had multiple enlarged vessels within the villous stroma, but we also found that new capillaries were formed by angiogenesis with endothelial cells derived from fibroblasts under the chronic hypoxic state.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Altshuler G (1984) Chorangiosis. An important placental sign of neonatal morbidity and mortality. Arch Pathol Lab Med 108:71–74

    PubMed  CAS  Google Scholar 

  2. Soma H, Watanabe Y, Hata T (1995) Chorangiosis and chorangioma in three cohorts of placentas from Nepal, Tibet and Japan. Reprod Fertil Dev 7:1533–1538

    Article  PubMed  CAS  Google Scholar 

  3. Soma H, Hata T, Oguro T, Fujita K, Kudo M, Vaidya U (2005) Characteristics of histological and ultrastructural features of placental villi in pregnant Nepalese women. Med Mol Morphol 38:92–103

    Article  PubMed  Google Scholar 

  4. Schwartz DA (2001) Chorangiosis and its precursors: underdiagnosed placental indicators of chorionic fetal hypoxia. Obstet Gynecol Surv 56:523–525

    Article  PubMed  CAS  Google Scholar 

  5. Kingdom JCP, Kaufman P (1997) Oxygen and placental villous development: origins of fetal hypoxia. Placenta 18:613–621

    Article  PubMed  CAS  Google Scholar 

  6. Pfarrer C, Macara L, Leiser R, Kingdom J (1999) Adaptive angiogenesis in placentas of heavy smokers. Lancet 354:303

    Article  PubMed  CAS  Google Scholar 

  7. Franciosi RA (1999) Placental pathology casebook. Perinatal/neonatal casebook. J Perinatal 19:393–394

    Article  CAS  Google Scholar 

  8. Asan E, Kaymaz FF, Cakar AN, Dagdeviren A, Beksac MS (1999) Vasculogenesis in early human placental villi: an ultrastructural study. Am Anat 181:549–554

    Article  CAS  Google Scholar 

  9. Demir R, Kaufman P, Castelluci M, Erbengi T, Kotowski A (1989) Fetal vasculogenesis and angiogenesis in human placental villi. Acta Anat 136:190–203

    Article  PubMed  CAS  Google Scholar 

  10. Shaut CAE, Keene DR, Sorensen LK, Li DY, Stadler S (2008) HOXA13 is essential for placental vascular patterning and labyrinth endothelial specification. PLoS Genet 4:1–18

    Article  Google Scholar 

  11. Reshetnikova OS, Burton GJ, Milovanov AP, Fukin EI (1996) Increased incidence of placental chorangioma in high-altitude pregnancies: hypobasic hypoxia as a possible etiologic factor. Am J Obstet Gynecol 174:557–561

    Article  PubMed  CAS  Google Scholar 

  12. Soma H (2001) Lessons from Nepalese placentas: based on 20 years’ pathologic studies. Industrial Publishing & Consulting, Tokyo

    Google Scholar 

  13. Baergen RN (2005) Manual of Benirschke and Kaufman’s pathology of the human placenta. Springer, New York, pp 358–359

    Google Scholar 

  14. Ahmed A, Dunk C, Ahmad S, Khaliq A (2000) Regulation of placental vascular endothelial growth factor (VEGF) and placenta growth factor (PIGF) and soluble Flt-1 by oxygen: a review. Placenta 21(Suppl A):S16–S24

    Article  PubMed  Google Scholar 

  15. Ogino S, Redline RW (2000) Villous capillary lesions of the placenta: distinctions between chorangioma, chorangiomatosis and chorangiosis. Hum Pathol 31:945–954

    Article  PubMed  CAS  Google Scholar 

  16. Thornburg KL, O’Tierney RF, Louey S (2010) Review: The placenta is a programming agent for cardiovascular disease. Placenta 31(Suppl A):S54–S59

    Article  PubMed  Google Scholar 

  17. Tantbirojn P, Saleemuddin A, Sirois K, Boyd TK, Tworoger S, Parast MM (2009) Gross abnormalities of the umbilical cord: related placental histology and clinical significance. Placenta 30:1083–1088

    Article  PubMed  CAS  Google Scholar 

  18. Sepulveda W, Nicolaidis P, Bower S (1996) Common iliac artery flow velocity waveforms in fetuses with a single umbilical artery. A longitudinal study. Br J Obstet Gynecol 103:660–663

    Article  CAS  Google Scholar 

  19. Kikuchi M, Soma H, Minatoguchi M, Oguro T, Itakura A, Ishihara O, Tanaka K, Murai N, Mineo S, Fujita K (2011) Fetal cardiac vascular anomalies and placental pathology. Obstet Gynecol 78:682–686 (in Japanese)

    Google Scholar 

  20. Risau W, Sariola H, Zerwes H-G, Sasse J, Ekblom P, Kemler R, Doetschman T (1988) Vasculogenesis and angiogenesis in embryonic-stem-cell-derived embryoid bodies. Development (Camb) 102:471–478

    CAS  Google Scholar 

  21. Noack F, Sotlar K, Thorns C, Snucek J, Diedrich K, Feller AC, Horny H-P (2003) VEGF-, KIT protein-, and neutral endopeptidase (NEP/CD10)-positive myofibroblasts: precursors of angiogenesis in chorioangiomas? Placenta 24:758–766

    Article  PubMed  CAS  Google Scholar 

  22. Kon K, Fujiwara T (1994) Transformation of fibroblasts into endothelial cells during angiogenesis. Cell Tissue Res 278:625–628

    Article  PubMed  CAS  Google Scholar 

  23. Oguro T, Ohaki Y, Asano G, Ebina T, Watanabe K (2001) Ultrastructural characterization of the role of fibroblasts in tumor microvessel networking. Jpn J Clin Electron Microsc 33:131–135

    Google Scholar 

Download references

Acknowledgments

The authors thank Professor M. Kudo, Pathology Laboratory, Toda Central Hospital, for kindly checking the paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hiroaki Soma.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soma, H., Murai, N., Tanaka, K. et al. Angiogenesis in villous chorangiosis observed by ultrastructural studies. Med Mol Morphol 46, 77–85 (2013). https://doi.org/10.1007/s00795-013-0010-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00795-013-0010-7

Keywords

Navigation