Abstract
In placentas from uncomplicated pregnancies, Hofbauer cells either disappear or become scanty after the fourth to fifth month of gestation. Immunohistochemistry though, reveals that a high percentage of stromal cells belong to Hofbauer cells. The aim of this study was to investigate the changes in morphology and density of Hofbauer cells in placentas from normal and pathological pregnancies. Seventy placentas were examined: 16 specimens from normal term pregnancies, 10 from first trimester's miscarriages, 26 from cases diagnosed with chromosomal abnormality of the fetus, and placental tissue specimens complicated with intrauterine growth restriction (eight) or gestational diabetes mellitus (10). A histological study of hematoxylin-eosin (HE) sections was performed and immunohistochemical study was performed using the markers: CD 68, Lysozyme, A1 Antichymotrypsine, CK-7, vimentin, and Ki-67. In normal term pregnancies, HE study revealed Hofbauer cells in 37.5% of cases while immunohistochemistry revealed in 87.5% of cases. In first trimester's miscarriages and in cases with prenatal diagnosis of fetal chromosomal abnormalities, both basic and immunohistochemical study were positive for Hofbauer cells. In pregnancies complicated with intrauterine growth restriction or gestational diabetes mellitus, a positive immunoreaction was observed in 100 and 70% of cases, respectively. Hofbauer cells are present in placental villi during pregnancy, but with progressively reducing density. The most specific marker for their detection seems to be A1 Antichymotrypsine. It is remarkable that no mitotic activity of Hofbauer cells was noticed in our study, as the marker of cellular multiplication Ki-67 was negative in all examined specimens.
Highlights
From the middle of the 19th century, several studies have reported the presence of large cells in the stroma of chorionic villi of the human placenta
Multiple sections from 70 specimens of whole placental tissue were examined: 16 specimens were received from normal term pregnancies; 10 from first trimester’s miscarriages; 26 from pregnancies between the 13th and 23rd week of gestation, diagnosed with chromosomal abnormality of the fetus, that were led to termination; eight from pregnancies between the 32nd and 38th week of gestation, complicated with intrauterine growth restriction (IUGR); and, 10 specimens were received from pregnancies between the 32nd and 38th week of gestation, associated with gestational diabetes mellitus
Additional immunohistochemical study revealed, via the macrophage marker A1 Antichymotrypsine, focal density of HBCs in 14/16 (87.5%) specimens, while positive immunostain was noticed for the marker CD 68 as well in half of the cases
Summary
From the middle of the 19th century, several studies have reported the presence of large cells in the stroma of chorionic villi of the human placenta. The precise location of these cells in the villous stroma was first described by Kastschenko in 1885, while Virchow, and later Chaletzky and Neumann first commented on the association of hydatidiform mole with large isolated cells having clear cytoplasm. This finding led to the term Chaletzky-Neumann cells, used in the past by several investigators. HBCs have been described as frequent, pleomorphic cells of the villous stroma with round, fusiform, or stellate appearance. Their size depends on the length of their processes. Later investigations have pointed out that HBCs are characterized by numerous membrane-bound, electron-lucent vacuoles of different sizes, possessing amorphous material of varying density, dense granules (presumably lysosomes), and short profiles of endoplasmic reticulum[1,3,4,5,6,7]
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