Diffuse decidual leucocytoclastic necrosis and NK cell aggregates: two distinct features of miscarriage. Issue 2 (5th November 2014)

• Record Type: Journal Article
• Authors: Lee, Joong Yeup; Kim, Eun Na; Hong, Joon-Seok; Shim, Jae-Yoon; Hwang, Doyeong; Kim, Ki Chul; Lee, JungBok; Kim, Chong Jai
• Is Part Of: Journal of clinical pathology. Volume 68:Issue 2(2015)
• Page Start: 119
• Page End: 124
• Publication Date: 2014-11-05
• Subjects: GYNAECOLOGICAL PATHOLOGY -- PREGNANCY -- FERTILITY; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jclinpath-2014-202470
• Languages: English
• ISSNs: 0021-9746

Abstract

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.