超常胎盘部位反应的病理学与临床特点

研究超常胎盘部位反应的病理与临床特点,提出诊断标准及鉴别诊断要点。方法 对１３例经病理检查诊断为ＥＰＳ的病人,采用免疫组化标记法,进行病理学特征,临床表现及预后分析。结果 ＥＰＳ组织学特征为以中间型为主的滋细胞向蜕膜及平滑肌层当润,不破坏原有组织结构,并保留部分胎盘特点。

The clinical and pathological characteristics of exaggerated placental site

Objectives To study the pathological and clinical features of exaggerated placental site (EPS) and to propose its diagnostic criteria and differential diagnosis. Methods The pathological features, immunohistochemical marks, clinical characteristics and prognosis of 13 cases with EPS were studied and analyzed.Results The histological feature of EPS was that trophoblasts mainly intermediate trophoblast (IT), infitrated into decidua and myometrium layers, while original histological structure was not destroyed, and placental site features remained partially. The immunohistochemical marks of EPS, HPL and EMA, were positive or strongly positive. The primary clinical presentation of EPS was postpartum hemorrhage and the prognosis was good in 5 years. Conclusions EPS is a kind of gestational trophoblastic disease primarily involving IT. It may be a preneoplastic lesion of placental site trophoblastic tumor (PSTT). Its differential diagnosis depend on combining histological, immunohistochemical findings, and clinical features. Attentions should be paid to EPS in cases with postpartum hemorrhage.