This image is from the membrane sample of a 33 week gestation infant with preterm labor (10x objective). There is an eosinophilic streak parallel to the chorion in the superficial decidua. This is not an uncommon finding. Is this old hemorrhage, fibrinoid from above chorion, old coagulative necrosis of the decidua, ruptured secretory gland material or seepage of protein from capillaries? Immunostains for fibronectin, fibrin etc. could narrow the type of material. Without hemosiderin, it is hard to prove old hemorrhage. There is no contact with chorion to suggest fibrinoid which can be prominent at the junction. Superficial decidual necrosis is common but usually includes the chorion epithelium, and does not leave a layer of intact decidua above it. Secretory gland material usually has a lighter pink more fluid appearance, and would not be linear. The presence of lymphocytes in the material suggests possible cell injury perhaps from natural killer cells. Anyone know what causes this common appearance?
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