输卵管妊娠的病理表现与早期水泡状胎块的鉴别诊断

目的探讨输卵管妊娠与早期水泡状胎块的鉴别诊断。方法对32例输卵管妊娠病理标本进行回顾性分析,观察绒毛的镜下改变,并复习相关文献。结果 32例输卵管妊娠标本中,25例部分绒毛有水肿,10例有中央池形成,7例个别绒毛呈扇贝状,5例绒毛间隙成片滋养细胞轻度异型,2例种植部位滋养细胞轻度异型,2例个别绒毛滋养细胞环绕绒毛花边样增生。结论输卵管妊娠的病理表现主要为绒毛水肿、绒毛中央池形成、扇贝状绒毛、个别绒毛滋养细胞环绕绒毛花边样增生、滋养细胞异型。病理诊断应与水泡状胎块进行鉴别。

The differential diagnosis of tubal pregnancy and early hydatidiform mole through pathology

Objective To investigate the pathology method of early hydatidiform mole（ HM） in tubal pregnancy. Methods Specimens of 32 cases of tubal pregnancy were gotten for re-reading and obseving the changes of microscope,and the related literature were reviewed. Results In the 32 cases,25 cases showed edema of partial villi,10 cases showed central pool forming,7 cases showed individual villus with the form of scallops,5 cases showed schistose trophoblast cells with mild atypia in intervillous space,2 cases showed trophoblast cells with mild atypia at planting site,2 cases showed individual villus trophoblast cells wrapping villus lacy hyperplasia of trophoblast cells.Conclusion Tubal pregnancy could showed edema of villi,central pool formation,scallop-like villus,individual villus wrapping villus lacy hyperplasia of trophoblast cells,trophoblast cells atypia,and just through light microscopic morphology alone it could easily be misdiagnosed as hydatidiform mole. To avoid the misdiagnosis,it should be neccessary to found other method of differential diagnosis on the basis of light microscopic observation.