超常胎盘部位的病理学研究(附5例报告)

目的探讨超常胎盘部位(EPS)反应的临床病理特点及其鉴别诊断要点。方法对5例经病理诊断为EPS的患者,采用免疫组化标记法及光镜,进行临床病理研究与分析。结果EPS组织学特征为以中间型为主的滋养细胞(IT)向蜕膜及平滑肌浸润,不破坏原有组织结构,同时保持部分胎盘的结构特点。免疫组化表现为胎盘泌乳素(HPL)、上皮膜抗原(EMA)呈阳性或强阳性,人绒毛膜促性腺素(ECG)阴性或弱阳性,波形蛋白(Vim)阴性。结论EPS反应为绒毛外中间型滋养细胞的良性非肿瘤性病变,是妊娠状态下中间型滋养细胞在胎盘部位的过度反应。鉴别诊断应结合光镜、免疫组织化学及临床表现综合判断。

Pathology study on exaggerated placental site: A report of 5 cases

Objective To investigate clinicopathological characteristics and differential diagnosis of ex-aggerated placental site (EPS).Methods The pathological features of 5 cases with EPS were studied and analyzed by immunohistochemical staining and light microscopey.Results The histological features of EPS were that trophoblasts, mainly intermediate trophoblast (IT), infiltrated into decidua and myometrium layers, while original histological structure of placenta was not destroyed,and former placental site features remained partially.The immunohistochemical marks of EPS, HPL and EMA, were positive or strongly positive, HCG negative or weakly positive and Vim negative. Conclusion EPS,which is IT's excess reaction in placental site, is a kind of benign non-neoplastic disease of IT cell outside chorion. Its differential diagnosis depends on combining light microscopy,immunohistochemistry and clinical features.