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Clinico-pathological profile of 12 cases of chorangiosis
Ruchika Gupta1, Sonu Nigam, Prerna Arora
1Department of Pathology, Maulana Azad Medical College, New Delhi, India.
Insights
Chorangiosis, a placental vascular lesion, is linked to serious maternal conditions like syphilis and pre-eclampsia. Recognizing chorangiosis in pathology reports is crucial for identifying associated risks and guiding patient care.
Area of Science:
- Pathology
- Feto-maternal medicine
- Vascular biology
Background:
- Chorangiosis is a placental vascular lesion affecting terminal chorionic villi.
- It is frequently associated with feto-maternal conditions such as pre-eclampsia and diabetes.
- The clinical significance of chorangiosis requires further extensive study.
Observation:
- A retrospective review identified 12 cases of chorangiosis, primarily in term gestations.
- Five cases were associated with maternal conditions: syphilis (2), pre-eclampsia (1), diabetes (1), and jaundice (1).
- Seven of the 12 cases resulted in stillbirth; one case each had abruptio placenta and non-immune hydrops.
Findings:
- Microscopic examination revealed extensive chorangiosis in all 12 cases, with focal infarction in two and calcification in one.
- Immunostaining confirmed increased capillary density (CD34 positive) and excluded chorangiomatosis (muscle-specific actin negative).
- The study identified characteristic pathological features for chorangiosis, differentiating it from chorangioma and chorangiomatosis.
Implications:
- Chorangiosis has significant clinical implications and warrants inclusion in pathology reports.
- Patients with chorangiosis should be investigated for associated conditions like syphilis, pre-eclampsia, and diabetes.
- Accurate diagnosis and reporting of chorangiosis are essential for appropriate feto-maternal risk assessment and management.
Abstract:
Chorangiosis is one of the vascular lesions that involves terminal chorionic villi. It is commonly associated with various feto-maternal conditions like pre-eclampsia, diabetes etc. However, the clinical significance of this pathological finding has not been studied extensively. The aim of this study was to identify the various conditions associated with chorangiosis and to determine its clinical significance. A retrospective study to identify the cases of placentas diagnosed with chorangiosis was carried out and the clinical and morphological details of these cases were reviewed. Immunostaining for CD34 and muscle-specific actin was also performed to confirm chorangiosis and to exclude chorangiomatosis. A total of 12 cases of chorangiosis were retrieved, most of them were of term gestation. Five of these 12 cases were associated with various maternal conditions including syphilis (2 cases) and single cases of pre-eclampsia, diabetes and jaundice. One case in each had abruptio placenta and non-immune hydrops. Of these 12 cases, seven were stillborn. Microscopically, all 12 cases showed extensive chorangiosis involving terminal villi. In addition, two cases showed focal infarction and one had extensive calcification. Immunostaining for CD34 confirmed increased number of capillaries while muscle-specific actin was negative, excluding chorangiomatosis. The clinico-pathological profile presented in this study suggests that chorangiosis has characteristic pathological features for its recognition and needs to be differentiated from similar conditions like chorangioma and chorangiomatosis. Also, chorangiosis has potential clinical significance and should be mentioned in the pathology report and the patient should be investigated for associated conditions like syphilis, pre-eclampsia, diabetes etc.
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