bromochloroacetic-acid and Placenta-Diseases

To investigate the clinicopathological features of intermediate trophoblastic non-tumor lesions, and to evaluate the position of immunohistochemistry in differential diagnoses.. Clinical presentation and morphological study of 15 cases of exaggerated placental site (EPS) and 4 cases of placental site nodule or plaque (PSNP) were reviewed. Immunohistochemical stains for hCG, hPL, inhibin-alpha, PLAP, CK18 and Ki-67 were performed.. The age of patients ranged from 25 to 40 years with an average of 31.5 years for EPS and 26 to 39 years with an average of 34.3 years for PSNP. Microscopically, EPS was characterized by cords and small sheets of implantation site intermediate trophoblasts infiltrating the endometrium, myometrium and arterial walls. The general histological structures of the endometrium and myometrium were preserved. PSNP was characterized by multiple circumscribed nodular lesions consisting of so-called chorionic-type intermediate trophoblasts and hyaline-like matrix present in the endometrium. Immunohistochemical stainings for hPL and CK18 were positive in the 15 EPS cases. Immunoreactivity for CK18, Inhibin-alpha and PLAP was detected in 4 PSNP cases. The Ki-67 labeling index in 15 EPS cases was low (< or = 5%), while Ki-67 index in 4 PSNP cases was close to 0.. The clinical presentation and pathological features of EPS and PSNP differ from those of trophoblastic tumors (placental site trophoblastic tumor, epithelioid trophoblastic tumor and choriocarcinoma). Immunochemical staining is of great value in their differential diagnoses.

Topics: Adult; Diagnosis, Differential; Endometrium; Female; Follow-Up Studies; Humans; Hysterectomy; Inhibins; Keratins; Myometrium; Placenta; Placenta Diseases; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Trophoblastic Tumor, Placental Site; Trophoblasts; Uterine Neoplasms

An immunohistochemical study analyzing distributions of beta-subunit human chorionic gonadotropin (beta HCG), human placental lactogen (HPL), placental alkaline phosphatase (PLAP), and monoclonal anti-cytokeratin (PKK1) was undertaken to determine whether the reactivity of these antigens might assist in the differential diagnosis of molar and non-molar hydropic placentas. A total of 16 complete hydatidiform moles, 15 partial hydatidiform moles, 12 hydropic abortuses and 39 non-hydropic placentas with gestational age ranging from 4 to 40 weeks was examined. In both the complete and partial moles, many syncytiotrophoblasts stained for beta HCG, HPL, PLAP and PKK1 although the staining intensity of beta HCG in the partial moles was weak compared with the complete moles. The staining patterns in the hydropic abortuses were almost the same as those in the normal first trimester placentas and had no distinct features from the partial moles. Trophoblastic hyperplasia is an essential feature in differentiating partial moles from hydropic abortuses. With regard to the immunostaining patterns of these antibodies, there was no significant difference to enable delineation between partial and complete moles, or between a hydropic abortus and a partial mole. Monoclonal anti-cytokeratin was most sensitive for trophoblasts, but less specific for intermediate trophoblasts than HPL. Although an immunohistochemical study using antibodies against beta HCG, HPL, PLAP and PKK1 is very useful for characterizing various trophoblasts, it is considered that an immunohistochemical study may not be a suitable tool for the differential diagnosis of molar and non-molar hydropic placentas.

Topics: Adolescent; Adult; Alkaline Phosphatase; Antibodies, Monoclonal; Biomarkers, Tumor; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Diagnosis, Differential; Female; Humans; Hydatidiform Mole; Hydrops Fetalis; Immunohistochemistry; Keratins; Peptide Fragments; Placenta; Placenta Diseases; Placental Lactogen; Ploidies; Pregnancy; Uterine Neoplasms

We report two cases of placental site nodule in which Mallory's bodies were found in the intermediate trophoblasts constituting the lesion. Mallory's bodies are known to occur in hepatocytes and pulmonary alveolar cells in a wide variety of conditions, and represent abnormal cytoplasmic aggregates of cytokeratin intermediate filaments. Their occurrence outside the liver and lung is exceptional. In the present cases, they were immunoreactive for both low- and high-molecular-weight cytokeratins. Since high-molecular-weight cytokeratin is not normally expressed in intermediate trophoblasts, the formation of Mallory's bodies appears to involve aberrant expression of cytoskeletal proteins.

Topics: Adult; Cytoskeletal Proteins; Female; Humans; Inclusion Bodies; Intermediate Filaments; Keratins; Placenta; Placenta Diseases; Pregnancy; Pregnancy Complications