Dept Of Pathology Research Articles

Histomorphological spectrum of kidney lesions in nephrectomies and autopsies in a tertiary care center with an emphasis on primitive neuroectodermal tumor/ewings sarcoma

Nephrectomy is one of the commonest surgeries done in urology for kidney lesions. Routinely, kidney specimens from autopsy are being sent to look for morphological changes occurring in both natural and unnatural deaths. Primitive neuroectodermal tumor/Ewing’s Sarcoma (PNET/ES), a member of Ewing’s sarcoma family is an aggressive tumor rarely observed in kidney principally occurs in young patients and is very rare in older patients. Hence this study was undertaken to contemplate the histomorphological pattern of kidney lesions in nephrectomy and autopsy specimens with an accentuation on Primitive Neuroectodermal tumor in Kidney which is a rare disease.This study was carried out in the Dept of Pathology, MMCRI, Mysore, Karnataka. All the nephrectomy and autopsy specimens received over a period of one year (June 2018 to May 2019) were included. A total of 38 cases were studied during this period. Out of 38 cases, 29 were non-neoplastic and 9 were neoplastic lesions. Among non-neoplastic, 19 were chronic pyelonephritis and in neoplastic, renal cell carcinoma clear cell type (5 cases) was the commonest with a case of renal PNET (rPNET).The present study provides a fair insight into the histological patterns of lesions in nephrectomy and autopsy specimen as they are liable for a great deal of morbidity and mortality. Histomorphological study of kidney lesions should be done thoroughly for early identification and prevention of progression of disease, and for prognosis and treatment.Also features infrequent occurrence of PNET/ES of the kidney which is uncommon and is significantly rarer in older patients.

SPECTRUM OF HISTOPATHOLOGICAL LESIONS OF FEMALE GENITAL TRACT - STUDY IN A TERTIARY CARE CENTRE

Introduction: (1) The female genital tract is constituted by the ovaries, fallopian tubes, uterus (body/corpus and cervix), vagina, and vulva. Female genital tract lesions can be benign or malignant. Our study was carried out to nd out the frequency of various histopathological lesions including neoplasms of female genital tract. Materials and Methods: Our study is retrospective conducted over 2 years period. Data was collected from case records of patients presenting to Goa Medical College and histopathology reports obtained from Dept of pathology. Data was represented in form of charts and tables. The analysis of statistical data of variables was done using SPSS software version 22. Signicance was calculated using chi square test. Value of p <0.05 was considered signicant. Results: Out of total 270 subjects studied, 229 were having benign lesions and 41 had malignant lesions.The mean age was 49.5 years. Leiomyoma was diagnosed in (40.58%) cases. In abnormalities of endometrium proliferative endometrium was seen in 37.6%. Chronic cervicitis was seen 78.74% cases. Among the ovarian lesions, 67.74% cases were simple follicular cysts. Cervical cancer was found in 73.17% cases followed by ovarian malignancies in 19.51 % cases, endometrial carcinoma in 4.87% cases and vulvar cancer in 2.44% cases. Among the malignant tumors (58.54%) cases were postmenopausal women. Conclusion: Microscopic assessment and clinico-pathological correlation of lesions is necessary as grossly identiable benign lesion may harbour a focus of malignancy. It aids to appropriate management in the postoperative period. A concerted effort should be done towards prevention of cancers, by creating awareness through health education in addition to implementation of screening methods.

Canadian Association of Neuropathologists L’Association Canadienne des Neuropathologistes

Abstracts and unknown cases presented at the 58th annual meetingThe Canadian Association of Neuropathologists (CANP) held their 58th annual meeting at the Halifax Harbourfront Marriott from October 3rd to 6th, 2018, under the leadership of Dr Marc Del Bigio, CANP president, and Dr. Sidney Croul handled the local arrangements. The annual banquet was held at Chives restaurant in Halifax.The academic program of 20 scientific abstracts and 8 unknown cases was compiled by the CANP Secretary-Treasurer Dr Julia Keith into 5 sessions; I. Traumatic and Neurodegenerative Neuropathology, II. Pediatric, Epilepsy and Miscellaneous Neuropathology, III. Tumour Neuropathology, IV. Infectious/Immune Mediated Neuropathology, and V. Quality Assurance in Neuropathology. The Quality Assurance session included a guided interactive forum led by Dr Marc Del Bigio, and the Neurodegenerative session included an invited talk on Butyrylcholinesterase as a Biomarker for Alzheimer’s Disease by Dr Sultan Darvesh (Faculty of Medicine, Dalhousie University). The digital pathology images from the 8 unknown cases are available for viewing online (www.canp.ca) thanks to the CANP webmaster, Dr Jason Karamchandani.The Presidential Symposium explored the theme of Brain Inflammation. Dr Sean Pittock (Dept of Neurology, Mayo Clinic, Rochester, MN) delivered the Dr Jerzy Olszewski Guest Lecture entitled Neural autoantibody discovery: the new era of autoimmune neurology – out with the old and in with the new! Dr Christian Pagnoux (Vasculitis Clinic, Mount Sinai Hospital, Toronto ON) was an invited speaker who spoke on Vasculitis – effects on the nervous system. Dr Alex Easton (Dept of Pathology, Dalhousie University, Halifax NS) was the Dr Gordon Mathieson invited lecturer speaking about The blood brain barrier and inflammation, and Dr Serge Rivest (Directeur du Centre de Recherche du CHU de Québec, Université Laval, Quebec QC) delivered the Dr David Robertson invited lecture on Microglial roles in human neuropathology. The symposium concluded with a panel discussion and group Question and Answer session with the speakers moderated by Dr Marc Del Bigio.Several trainee awards were handed out. The Dr Mary Tom Award for best clinical science paper was awarded to Dr Maryam Abdollahi (supervisor Dr David Munoz) and the Dr Morrison H. Finlayson Award for best basic science/research paper went to Dr Maliha Khara (Drs Zhou, Wong, Renwick).The following abstracts were presented at the 58th annual meeting of the Canadian Association of Neuropathologists (CANP) in October 2018.

BONE MARROW EXAMINATION IN VISCERAL LEISHMANIASES; A STUDY IN A TERTIARY CARE HOSPITAL.

10Apr 2019 BONE MARROW EXAMINATION IN VISCERAL LEISHMANIASES; A STUDY IN A TERTIARY CARE HOSPITAL. Nuzhat samoon , Irfan Hussain Bhat , Aijaz Muzamil , Sabiya Paddar , Tabassum and Huzaifa Nazier. senior resident, Dept of Pathology, SKIMS, Soura. PG residents, Dept of Pathology, SKIMS, Soura. Post MCH senior resident, Dept of Neurosurgery.SKIMS, Soura.

The prevalence of the accessory infraorbital foramen among sexes: preliminary results.

BRANIGAN L. MCGOWAN, DALTON S. BOLON, Dept of Natural Sciences & Mathematics, West Liberty University, West Liberty, WV, 26074, and MATTHEW J ZDILLA, Depts of Natural Sciences & Mathematics and Graduate Health Sciences, West Liberty University, West Liberty, WV, 26074 and Dept of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Morgantown, WV, 26506. The prevalence of the accessory infraorbital foramen among sexes: preliminary results.The infraorbital foramen is an opening in the maxillary bone below the infraorbital margin of the orbit through which the maxillary nerve travels. The infraorbital foramen is particularly important in nerve block procedures. Occasionally, an accessory infraorbital foramen may be present, complicating nerve block procedures. Therefore, this study assessed the prevalence of the accessory infraorbital foramen among sexes. A total of 565 crania of known sex were assessed (301 males and 264 females). In the total population, 108 of 565 crania (19.1%) were found to have an accessory IOF. With regard to sex, 66 of 301 males (21.9%) and 42 of 264 females (15.9%) were found to have an accessory IOF. The results of this study underscore the importance of screening for the accessory infraorbital foramen in both males and females prior to infraorbital nerve block.

Cellularised collagen-based scaffolds for engineering the vascular wall: a tri-culture study

Event Abstract Back to Event Cellularised collagen-based scaffolds for engineering the vascular wall: a tri-culture study Caroline Loy1, Daniele Pezzoli1, Jayachandran N. Kizhakkedathu2 and Diego Mantovani1 1 CHU de Quebec, Research Center, Laval University, Lab. for Biomaterials and Bioengineering, CRC-1, Dept. Min-Met-Materials Eng, Canada 2 The University of British Columbia, Centre for Blood Research, Dept of Pathology and Lab Med, Dept of Chemistry, Canada Introduction: Engineered vessel walls have the potential to be used instantly as an in vitro models of vascular tissue for the investigation of patho/physiological processes and as preclinical tests for drugs and devices[1]. Herein, we describe the development of a collagen-gel based tri-culture model closely mimicking the tri-layered cellular organization of native arteries. Materials and Methods: Cellularized collagen gels were prepared as reported elsewhere[2]-[4]. A tri-step process was developed to produce the tri-layered construct. The external (adventitia) layer was composed of fibroblasts (FBs) and smooth muscle cells (SMCs) at a density of 106 cells/ml within collagen; the middle (media) layer of only SMCs (106 cells/ml); the innermost (intima) layer was obtained by seeding a monolayer of endothelial cells (ECs, 80 000 cells/cm2) over the media layer. A rotating bioreactor was used to seed ECs in the lumen of tubular systems. The degree of endothelialisation of the construct was investigated by fluorescence microscopy, phenotypic protein expression of calponin and alpha-actin by SMCs by western blot, and the blood compatibility of constructs by clotting time assay. Also, histological staining of transversal sections was performed to observe the organization of the construct and of the produced extra-cellular matrix. Results and Discussion: A tri-culture model of vascular wall with an organisation in multi-layer and a complete monolayer of ECs within 24 h for the flat model and 48 h for the tubular model was developed. Figure 1 clearly shows the organisation in two cellularized collagen gel layers and the presence of a monolayer of ECs. After 7 days, the compaction of the collagen matrix by vascular cells was achieved, and the deposition of ECM components such as fibronectin and fibrillin-1 was observed. Figure 2 confirmed that the ECs formed a continuous monolayer over the construct and did not migrate inside the collagen. The blood compatible functionality of the EC monolayer was demonstrated by the clotting time assay (Fig 3) showing that after 7 days of maturation clotting was prevented, with a concentration of free hemoglobin higher than 80% after 60 min of incubation (p > 0.05 between the endothelialized constructs and the non-endothelialized constructs). Also western blot results suggest that SMCs lose their contractile phenotype in the mono-culture while the contractile phenotype was not significantly affected in the tri- and bi- culture with a heterogeneous population of synthetic and contractile SMCs after 7 days of culture. Conclusion: The design of an in vitro vascular wall model in disk and tubular shape using collagen as scaffold was reported. This tri-culture engineered tissue promotes cell-matrix remodeling and improves the anticoagulant surface properties. This model is expected to allow the investigation the mutual intimate relationships existing among vascular cells thus representing a step forward into the engineering of in vitro vascular tissue models. This work was partially funded by NSERC-Canada, CIHR-Canada, FRQ-NT-Quebec, CFI-Canada. CL was awarded of a doctoral scholarship from NSERC Create Program in Regenerative Medicine (www.ncprm.ulaval.ca)

In memoriam: A life scientific--John Woodland 'Woody' Hastings (1927-2014).

LuminescenceVolume 29, Issue 8 p. 959-962 Obituary In memoriam: A life scientific - John Woodland ‘Woody’ Hastings (1927–2014) Larry J. Kricka, Corresponding Author Larry J. Kricka Philadelphia, PA, USA Correspondence to: Larry Kricka, Dept of Pathology & Lab Medicine, Univ of Pennsylvania Medical Center. E-mail: [email protected]Search for more papers by this authorPhilip E. Stanley, Philip E. Stanley Cambridge, UKSearch for more papers by this author Larry J. Kricka, Corresponding Author Larry J. Kricka Philadelphia, PA, USA Correspondence to: Larry Kricka, Dept of Pathology & Lab Medicine, Univ of Pennsylvania Medical Center. E-mail: [email protected]Search for more papers by this authorPhilip E. Stanley, Philip E. Stanley Cambridge, UKSearch for more papers by this author First published: 16 December 2014 https://doi.org/10.1002/bio.2827Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume29, Issue8December 2014Pages 959-962 RelatedInformation

A Cytohistological Correlation in Ovarian Tumours

The present study was conducted to assess whether imprint cytology can help in rapid diagnosis of ovarian neoplasm and thus facilitate individualized treatment. Aims of our study were to establish the validity and reliability of Imprint cytology in intraoperative diagnosis of ovarian tumour and to compare the significance of cytological diagnosis with histopathological report. Ours is an Institution base prospective study designed on 50 cases of clinically and radiologically diagnosed ovarian tumour at the Dept of pathology IPGME&R, Kolkata which is a tertiary care referral hospital. Imprint smears were made intraoperatively from fresh samples and stained with M.G.G. stain for air dried smears and Papanicolaou stain for alcohol fixed smears. Stained smear was examined under light microscope and cytological findings were noted. Tissue for histopathological study was obtained in the form of post operative material. The previous cytological findings were compared with subsequent histopathology report. Out of total 50 cases, 32(64%) was epithelial tumours and 18(36%) non-epithelial tumour cases. Age group varied from 5 to 62 years. Overall sensitivity in our study to diagnose benign and malignant ovarian tumours by imprint cytology is 94% and the specificity is 74% with positive and negative predictive value of 63% and 96% respectively. Diagnostic accuracy was 78% with high statistical significance (p<0.001). Hence we conclude that imprint cytology is a less expensive, simple, fast and reliable method for diagnosis of various ovarian neoplasms.

Synergistic effect of accumulated chlorpyrifos and raised levels of MDA and oestrogen induced ovarian cancer progression

Lethality of ovarian cancer (Oca) escalates due to lack of sufficient techniques for authentic prognosis. Many factors are responsible for the progression of cancer. Oca patients from Gangetic and Non- Gangetic were categorized to evaluate the effects of chlorpyrifos (organophosphate) on Oca patients. Oestrogen and several xenoestrogens are believed to be the primary causative agents for female gynaecological cancers. Mutagenecity caused by malondialdehyde (MDA), a by-product of lipid peroxidtaion (LPO) is also suggested to be a major source of many diseases, including cancers. Blood was sampled from Oca patients at Dept of Pathology, Mahavir Cancer Institute and research centre, India. A standard protocol was followed for Thiobarbituric acid reactive substance assay. Standard protocols were followed for the evaluation of various haematological parameters, estrogen level ( estrogen ELISA kit), blood chlorpyrifos detection ( reversephase HPLC), MDA level was significantly (P 0.05) difference between Gangetic and non- Gangetic Oca patients. However, the WBC values of Oca patients were significantly (P < 0.05) higher than those of healthy patients. Detection of chlorpyrifos in Oca patients suggests its genotoxic effect. Higher estrogen level in postmenopausal patients from both the zones indicates increased aromatase activity. Simultaneous effects of xenoestrogen and estrogen could be the possible cause of Oca development. Histopathological observations corroborates haematological and biochemical values. Since Gangetic and non-Gangetic parts of Bihar are pesticide-prone zones, the use of chlorpyrifos should be discouraged to avoid its genotoxic- gynecological effects leading to cancer. More studies are warranted to confirm the role of simultaneous effects of estrogen, xenoestrogens and MDA in the initiation and progression of gynaecological cancers in women.

Liver resection for metastatic periampullary cancer: Is it (sometimes) worthwile?

Liver resection for metastatic periampullary cancer: Is it (sometimes) worthwile?

MMP9 and S100A9 expression in peripheral blood mononuclear cells (PBMC) are correlated with PDAC and with PDAC-associated diabetes mellitus

MMP9 and S100A9 expression in peripheral blood mononuclear cells (PBMC) are correlated with PDAC and with PDAC-associated diabetes mellitus

Sequence analysis of the hepatitis C virus core gene: truncated core proteins encoded in hepatocellular carinomas: Rin Yamaguchi, Food and Drug Admin/CBER/OBRR/DETTD, Rockville, MD; Seiya Momosaki, Dept of Pathology, Kurume Univ, Kurume Japan; Chu C Hsia, Gao Guang, Food and Drug Admin/CBER/OBRR,DETTD, Rockville, MD; Masamichi Kojiro, Dept of Pathology, Kurume Univ, Kurume Japan; Charles Scudamore, Dept Surgery, Univ of British

Sequence analysis of the hepatitis C virus core gene: truncated core proteins encoded in hepatocellular carinomas: Rin Yamaguchi, Food and Drug Admin/CBER/OBRR/DETTD, Rockville, MD; Seiya Momosaki, Dept of Pathology, Kurume Univ, Kurume Japan; Chu C Hsia, Gao Guang, Food and Drug Admin/CBER/OBRR,DETTD, Rockville, MD; Masamichi Kojiro, Dept of Pathology, Kurume Univ, Kurume Japan; Charles Scudamore, Dept Surgery, Univ of British

Effects of immunomodulatory drugs of hepatic infiltration of CD8+ cells in D-galactosamine (D-GalN)-induced hepatic injury in rats: involvement of cytotoxic T lymphocyte (CTL)-like cells in early phase events of the pathological process: Mie Nishio, Toshikazu Ogawa, Noriaki Maeda, Medicinal Biology Research Labs, Fujisawa Pharmaceutical Co, LtD, Osaka Japan; Masayuki Ogami, Yoshihiro Ikura, Dept of Pathology, Osaka City University Medical School,

Effects of immunomodulatory drugs of hepatic infiltration of CD8+ cells in D-galactosamine (D-GalN)-induced hepatic injury in rats: involvement of cytotoxic T lymphocyte (CTL)-like cells in early phase events of the pathological process: Mie Nishio, Toshikazu Ogawa, Noriaki Maeda, Medicinal Biology Research Labs, Fujisawa Pharmaceutical Co, LtD, Osaka Japan; Masayuki Ogami, Yoshihiro Ikura, Dept of Pathology, Osaka City University Medical School,

Impact of lymphoproliferative disorders after pediatric liver transplant: a single center ten-year experience: Regino P González-Peralta, Cheryl W McGinnis, Donald A Novak, Christopher D Jolley, Pediatric Liver Transplant Program, Univ of Florida, Gainesville, FL; Suzanne Skoda-Smith, Pediatric Immunology, Univ of Florida, Gainesville, FL; Elizabeth L. Mackay, Pediatriac Liver Transplant Program, Univ of Florida, Gaineville, FL; Gregory V Scott, Dept of

Impact of lymphoproliferative disorders after pediatric liver transplant: a single center ten-year experience: Regino P González-Peralta, Cheryl W McGinnis, Donald A Novak, Christopher D Jolley, Pediatric Liver Transplant Program, Univ of Florida, Gainesville, FL; Suzanne Skoda-Smith, Pediatric Immunology, Univ of Florida, Gainesville, FL; Elizabeth L. Mackay, Pediatriac Liver Transplant Program, Univ of Florida, Gaineville, FL; Gregory V Scott, Dept of

Changes in the distribution of hepatocellular transporters in human end-stage cholestatic liver disease: P Milkiewicz, E Elias, A Williams, Liver Unit, Queen Elizabeth Hospital, Birmingham United Kingdom; M Milkiewicz, Dept of Physiology, University of Birmingham, Birmingham United Kingdom; A Keogh, Liver Unit, Queen Elizabeth Hospital, Birmingham United Kingdom; S G Hubscher, Dept of Pathology, University of Birmingham, Birmingham United Kingdom

Changes in the distribution of hepatocellular transporters in human end-stage cholestatic liver disease: P Milkiewicz, E Elias, A Williams, Liver Unit, Queen Elizabeth Hospital, Birmingham United Kingdom; M Milkiewicz, Dept of Physiology, University of Birmingham, Birmingham United Kingdom; A Keogh, Liver Unit, Queen Elizabeth Hospital, Birmingham United Kingdom; S G Hubscher, Dept of Pathology, University of Birmingham, Birmingham United Kingdom

The chemokine CXCL16 and its receptor CXCR6 are important for positioning of T cells within the liver: Heydtmann Mathis, Liver Research Labs, Birmingham Uk; Stephan Hübscher, Dept of Pathology, Birmingham Uk; Mike Briskin, Millenium Inc, Boston, MA; David H Adams, Liver Research Labs, Birmingham Uk

The chemokine CXCL16 and its receptor CXCR6 are important for positioning of T cells within the liver: Heydtmann Mathis, Liver Research Labs, Birmingham Uk; Stephan Hübscher, Dept of Pathology, Birmingham Uk; Mike Briskin, Millenium Inc, Boston, MA; David H Adams, Liver Research Labs, Birmingham Uk

Development of de novo autoimmune-like hepatitis following liver transplantation for primary sclerosing cholangitis: Timothy Gunneson, Russell Wiesner, David Brandhagen, Transplant Ctr, Mayo Clinic, Rochester, MN; Lawrence Burgart, Dept of Pathology, Mayo Clinic, Rochester, MN; K V Narayanan Menon, Transplant Ctr, Mayo Clinic, Rochester, MN

Development of de novo autoimmune-like hepatitis following liver transplantation for primary sclerosing cholangitis: Timothy Gunneson, Russell Wiesner, David Brandhagen, Transplant Ctr, Mayo Clinic, Rochester, MN; Lawrence Burgart, Dept of Pathology, Mayo Clinic, Rochester, MN; K V Narayanan Menon, Transplant Ctr, Mayo Clinic, Rochester, MN

B-cell lymphoproliferative and plasma cell disorders in individuals with chronic hepatitis C: Ramazan Idilman, Ankara Univ Medical Sch, Dept of Gastroenterology, Ankara Turkey; Alessandra Colantoni, Nicola De Maria, Loyola University Medical Center, Dept of Gastroenterology, Maywood, IL; Serhan Alkan, Loyola University Medical Center, Dept of Pathology, Maywood, IL; Sucha Nand, Loyola University Medical Center, Dept of Hemato-Oncology, Maywood, IL; Irfan

B-cell lymphoproliferative and plasma cell disorders in individuals with chronic hepatitis C: Ramazan Idilman, Ankara Univ Medical Sch, Dept of Gastroenterology, Ankara Turkey; Alessandra Colantoni, Nicola De Maria, Loyola University Medical Center, Dept of Gastroenterology, Maywood, IL; Serhan Alkan, Loyola University Medical Center, Dept of Pathology, Maywood, IL; Sucha Nand, Loyola University Medical Center, Dept of Hemato-Oncology, Maywood, IL; Irfan

Immunohistochemical study of mucosal addressin cell adhesion molecule-1 (MAdCAM-1) expression in primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC): Aftab Ala, Centre for Hepatology, London Uk; Richard Standish, Korsa Khan, Nidhi Prasad, Dept of Histopathology, Royal Free Hosp, London Uk; Kenneth Hillan, Dept of Pathology, Genentech, San Francisco, CA; Amar Dhillon, Dept of Histopathology, Royal Free Hosp, London Uk;

Immunohistochemical study of mucosal addressin cell adhesion molecule-1 (MAdCAM-1) expression in primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC): Aftab Ala, Centre for Hepatology, London Uk; Richard Standish, Korsa Khan, Nidhi Prasad, Dept of Histopathology, Royal Free Hosp, London Uk; Kenneth Hillan, Dept of Pathology, Genentech, San Francisco, CA; Amar Dhillon, Dept of Histopathology, Royal Free Hosp, London Uk;

Association of vaginal hydrolytic enzymes with amniotic fluid proinflammatory cytokines among women in preterm labor

PUZZLE? AMANDA COTTER, MLUNTHITA DUTHELY, M. J. O’SULLIVAN, RITA ROMAGUERA, University of Miami, Dept of Obstetrics and Gynecology, Miami, Florida, University of Miami, Dept of Pathology, Miami, Florida OBJECTIVE: To investigate the effect of HIV antiretroviral therapy (ARV) on placental pathology and to determine if there is an association with adverse pregnancy outcome. STUDY DESIGN: Using prospectively gathered data from our perinatal database, women diagnosed HIV positive prior to or during pregnancy with care at our prenatal clinic from 1992-2002 were identified. From a baseline cohort of 1151 women, placental specimens were available for 922. Placental pathology was categorized as chorioamnionitis, villitis, membranitis, funisitis, infarcts and thrombosis. RESULTS: The cohort comprised 780 women who received ARV in pregnancy (monotherapy in 361, combination without a protease inhibitor (PI) in 307, combination with a PI in 112) and 142 women who did not receive any ARV. As compared to combination therapy, women who received monotherapy had a higher rate of membranitis (P = .005). Adjusting for possible confounders, ARV was not associated with any significantly different placental pathology compared to women who received no ARV. However both combination therapy with a PI (OR 2.1, 1.2-3.5) and histological chorioamnionitis (OR 2.4, 1.1-5.1) were associated with an increased risk of preterm delivery before 37 weeks. In the absence of clinically evident chorioamnionitis, combination therapy with a PI was associated with evidence of histological chorioamnionitis and this increased the risk of preterm delivery ten-fold (P = .001) (OR 10.9, 2.8-43.1). CONCLUSION: The association of combination therapy with a protease inhibitor with histological chorioamnionitis as a risk factor for preterm delivery warrants further investigation.