Article Text

PDF
Diffuse decidual leucocytoclastic necrosis and NK cell aggregates: two distinct features of miscarriage
  1. Joong Yeup Lee1,
  2. Eun Na Kim2,3,
  3. Joon-Seok Hong4,
  4. Jae-Yoon Shim2,5,
  5. Doyeong Hwang1,
  6. Ki Chul Kim1,
  7. JungBok Lee6,
  8. Chong Jai Kim2,3
  1. 1Hamchoon Women's Clinic, Seoul, Republic of Korea
  2. 2Asan Laboratory of Perinatal Science, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
  3. 3Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
  4. 4Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
  5. 5Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
  6. 6Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
  1. Correspondence to Professor Chong Jai Kim, Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; ckim{at}amc.seoul.kr

Abstract

Aims Primary histopathology of miscarriage remains undetermined in the majority of cases. This study was conducted to determine histological characteristics pertinent to miscarriage.

Methods The study groups were composed of elective abortions (n=29) and miscarriages (n=45) comprised of chromosomally normal (n=15) and abnormal cases (n=30). Immunohistochemistry was done against CD3, CD8, TIA-1 and CD56.

Results Two histological features—diffuse decidual leucocytoclastic necrosis (DDLN) and decidual natural killer cell aggregates (NKCA)—were relatively common in miscarriages. The frequencies of DDLN and NKCA were different between the groups (p<0.05 and p<0.05, respectively). DDLN was found in 13.8% (4/29) of elective abortions, while it was observed in 60.0% (9/15) and 23.3% (7/30) of chromosomally normal and abnormal miscarriages, respectively. DDLN was more frequent in chromosomally normal miscarriages than in elective abortions (p=0.004). NKCA was present in 13.8% (4/29) of elective abortions, while being found in 33.3% (5/15) and 43.3% (13/30) of chromosomally normal and abnormal miscarriages, respectively. NKCA was more frequent in chromosomally abnormal miscarriages than in elective abortions (p=0.020).

Conclusions The findings strongly suggest that defective placentation and abnormal maternal immune response are associated with miscarriage. DDLN and NKCA seem to have diagnostic values in the pathological evaluation of miscarriage.

  • GYNAECOLOGICAL PATHOLOGY
  • PREGNANCY
  • FERTILITY

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.