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Abstract：
BACKGROUND: The study of pathologic diagnosis of placental TB is rare. The aim of this study is analyzing the pathomorphological characteristics of tuberculosis (TB) placenta during pregnancy and its clinical significance.
METHODS: Nineteen cases of placental tissue specimens during pregnancy were collected from June 2015 to February 2022 at Shanghai Public Health Clinical Center, the only inpatient center for pregnant women with TB in Shanghai, China. Hematoxylin-eosin staining, acid-fast staining, and molecular testing were applied to analyze them comprehensively in combination with clinical information.
RESULTS: Among the 19 cases, 7 cases caused intrauterine stillbirth, 3 cases received artificial abortion required by the pregnant woman, the other 9 cases received standard delivery and the infants survived, however, 3 of them were low-weight preterm infants, and another 1 case suffered mild intrauterine asphyxia. The 9 surviving infants were followed-up, of which 3 cases got congenital TB. For pathological characteristics of placental tissues under light microscopy, there were 3 cases of epithelioid granuloma formation, 13 cases of acute fetal membranitis, 4 cases of caseous necrosis, 7 cases of inflammatory necrosis, 10 cases of coagulative necrosis, and 6 cases with small focal calcifications. All placental tissues were positive for acid-fast staining and polymerase chain reaction (PCR). Molecular pathological diagnosis showed that 18 cases were positive for Mycobacterium tuberculosis, with 1 case not having received examination.
CONCLUSIONS: Combining acid-fast staining and molecular pathological testing is helpful for accurately diagnosing placental TB.
METHODS: Nineteen cases of placental tissue specimens during pregnancy were collected from June 2015 to February 2022 at Shanghai Public Health Clinical Center, the only inpatient center for pregnant women with TB in Shanghai, China. Hematoxylin-eosin staining, acid-fast staining, and molecular testing were applied to analyze them comprehensively in combination with clinical information.
RESULTS: Among the 19 cases, 7 cases caused intrauterine stillbirth, 3 cases received artificial abortion required by the pregnant woman, the other 9 cases received standard delivery and the infants survived, however, 3 of them were low-weight preterm infants, and another 1 case suffered mild intrauterine asphyxia. The 9 surviving infants were followed-up, of which 3 cases got congenital TB. For pathological characteristics of placental tissues under light microscopy, there were 3 cases of epithelioid granuloma formation, 13 cases of acute fetal membranitis, 4 cases of caseous necrosis, 7 cases of inflammatory necrosis, 10 cases of coagulative necrosis, and 6 cases with small focal calcifications. All placental tissues were positive for acid-fast staining and polymerase chain reaction (PCR). Molecular pathological diagnosis showed that 18 cases were positive for Mycobacterium tuberculosis, with 1 case not having received examination.
CONCLUSIONS: Combining acid-fast staining and molecular pathological testing is helpful for accurately diagnosing placental TB.
摘要：
背景：胎盘结核的病理诊断研究并不多见。目的分析妊娠合并结核(TB)胎盘的病理形态学特点及其临床意义。
方法：收集2015年6月至2022年2月上海市公共卫生临床中心妊娠期胎盘组织标本19例。上海唯一的结核病孕妇住院中心，中国。苏木精-伊红染色，耐酸染色,并结合临床资料对其进行分子检测综合分析。
结果：在19例中，7例宫内死胎，3例孕妇要求进行人工流产，其他9例接受标准分娩，婴儿存活，然而,其中3人是低体重早产儿，另有1例轻度宫内窒息。对9名幸存的婴儿进行了随访，其中3例患有先天性结核病。对于光镜下胎盘组织的病理特征，有3例上皮样肉芽肿形成，急性胎膜炎13例,4例干酪样坏死，7例炎性坏死，凝固性坏死10例，局灶性小钙化6例。所有胎盘组织的抗酸染色和聚合酶链反应（PCR）均为阳性。分子病理诊断结核分枝杆菌阳性18例,1例没有接受检查。
结论：抗酸染色与分子病理检测相结合有助于胎盘结核的准确诊断。
方法：收集2015年6月至2022年2月上海市公共卫生临床中心妊娠期胎盘组织标本19例。上海唯一的结核病孕妇住院中心，中国。苏木精-伊红染色，耐酸染色,并结合临床资料对其进行分子检测综合分析。
结果：在19例中，7例宫内死胎，3例孕妇要求进行人工流产，其他9例接受标准分娩，婴儿存活，然而,其中3人是低体重早产儿，另有1例轻度宫内窒息。对9名幸存的婴儿进行了随访，其中3例患有先天性结核病。对于光镜下胎盘组织的病理特征，有3例上皮样肉芽肿形成，急性胎膜炎13例,4例干酪样坏死，7例炎性坏死，凝固性坏死10例，局灶性小钙化6例。所有胎盘组织的抗酸染色和聚合酶链反应（PCR）均为阳性。分子病理诊断结核分枝杆菌阳性18例,1例没有接受检查。
结论：抗酸染色与分子病理检测相结合有助于胎盘结核的准确诊断。
