Qap (Anatomical Pathology) 

QAP Peer Review

AP189
Case History: F/24 Preterm labour, maternal fever, Caesarean section performed. Placental section for assessment.
Intended diagnosis: Syphilis. Contributed by:KFT
Code Diagnosis Comment Score
anonymous Acute suppurative villitis with microabscesses (100%), suggestive of listeria infection. Gram stain for gram-positive coccobacilli. ZN and Grocott stain to exclude other organisms. Correlate with culture result.  90
anonymous Necrotizing villitis with microabscesses formation (100%). Most important differential diagnoses including E Coli and Listerosis. Special stains for infective organisms (Gram). Correlation with microbiology results.  90
anonymous Acute villitis, 100% Suggestive of Listeria infection. Perform special stain for microorganisms (ZN, grocott, Warthin-Starry) and correlate with microbiologic results.  100
anonymous ACUTE NECROTIZING VILLITIS pattern suspicious of LISTERIOSIS. 100% Listeriosis can be highlighted by Warthin-Starry stain +/- immunostain. Differential includes other infective agent eg. toxoplasmosis(usually granulomatous inflammation). Immunostains, immunofluorescence and PCR can help. Also to correlate with microbiological studies.  100
anonymous Acute necrotizing and chronic villitis. (100%) Do infective stains e.g. Gram, Warthin Starry, Giemsa, Grocott, Ziehl Neelsen, etc to confirm/exclude infection such as syphilis, listeria, fungus, mycobacterium, etc.  100
anonymous Acute suppurative villitis and intervillositis 100% To correlate with microbiologic culture - for evidence of Listeria infection  90
anonymous Acute villitis, suggestive of Listeria infection (100%) To be confirmed by Gram stain (Listeria is a Gram positive bacillus) and culture.  90
anonymous Necrotizing villitis 100%, infective aetiology i.e. Listeria, toxoplasmaosis cannot be excluded suggest correlation with clinical history & microbiological investigation result  90
anonymous Necrotizing villitis (Acute/ active chronic villitis, intervillositis with villous necrosis). Viral or bacterial causes should be ruled out. Histochemical stain and immunohistochemistry test: Gram's Wahrthin Starry, GMS.  100
anonymous PLACENTA - NECROTISING VILLITIS. (100%) Please correlate with culture and serology. Organisms such as Listeria, rubella, toxoplasmosis, malaria should be considered and immunohistochemistry for CMV and herpes could be performed.  90
anonymous Acute intervillositis 100% Suggestive of Listeria monocytogenes infection Intervillous abscess formation with necrosis Perform: - organism stains: gram, PAS - blood culture  90
anonymous Acute suppurative villitis Correlate with microbiological studies to exclude Listeria  90
anonymous Acute suppurative villitis Can be caused by bacteria e.g. Streptococci, Staplylococcus, Hemophilus vaginalis, Listeria monocytogenes and different Gram-negative bacteria. Bacteriological culture should be done.  90
anonymous Acute intervillositis with microinfarct and microabscess, need to exclude bacterial infection like Listeria Monocytogenes Perform Gram stain and correlate with culture. Probability: 100% nil  90
anonymous Necrotising villitis with microabscesses; Listeria infection has to be considered 100% Special stains to look for bacterial, fungal and acid fast organisms. Correlate with clinical and culture findings. If possible, immunohistochemical stain for Listeria antigens  90
anonymous Acute intervillositis. Order tissue Gram's stain for bacteria such as Listeria.  90