Difference between revisions of "Trophoblast"

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| inhibin+, hPL+, beta-hCG-<ref name=pmid1694585>{{cite journal |author=Yeh IT, O'Connor DM, Kurman RJ |title=Intermediate trophoblast: further immunocytochemical characterization |journal=Mod. Pathol. |volume=3 |issue=3 |pages=282–7 |year=1990 |month=May |pmid=1694585 |doi= |url=}}</ref>
| inhibin+, hPL+, beta-hCG-<ref name=pmid1694585>{{cite journal |author=Yeh IT, O'Connor DM, Kurman RJ |title=Intermediate trophoblast: further immunocytochemical characterization |journal=Mod. Pathol. |volume=3 |issue=3 |pages=282–7 |year=1990 |month=May |pmid=1694585 |doi= |url=}}</ref> CD146+,<ref name=pmid10451481>{{Cite journal  | last1 = Shih | first1 = IM. | title = The role of CD146 (Mel-CAM) in biology and pathology. | journal = J Pathol | volume = 189 | issue = 1 | pages = 4-11 | month = Sep | year = 1999 | doi = 10.1002/(SICI)1096-9896(199909)189:14::AID-PATH3323.0.CO;2-P | PMID = 10451481 }}</ref> p63-
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Revision as of 22:56, 9 March 2012

Trophoblast is part of a normal pregnancy. Trophoblasts are derived from the conceptus, i.e. not maternal. Part of the trophoblast forms chorionic villi.

Tumours arising from the trophoblast are dealt with in gestational trophoblastic disease.

Trophoblast table

Based on Shih et al.:[1]

Cytotrophoblast Syncytiotrophoblast Villous intermediate
trophoblast 		Implanation site
intermediate trophoblast 		Chorionic-type
intermediate trophoblast
Nuclear features round, small multinucleated polyhedral pleomorphic +/-multinucleation
(occasional), +/-nucleoli 		round / polyhedral
Cell borders well-defined poorly defined (?) well-defined moderately-defined poorly defined (?)
Cytoplasm minimal, clear to granular abundant, vacuolated abundant & eosinophilic to clear abundant & eosinophilic abundant & eosinophilic
Location villi - deep to
syncytiotrophoblast 		villi - superficial to
cytotrophoblast -
nearest to maternal blood 		villi implanatation site chorion
Function stem cell, produces beta-hCG[2] produces hormones ??? anchor placenta ???
IHC beta-hCG ??? beta-hCG ??? inhibin+, hPL+, beta-hCG-[3] CD146+,[4] p63- hPL+/-, p63+, CD146-
Image ST (jhu.edu)[5] CT (jhu.edu)[5] (WC)
Associated tumour Choriocarcinoma Choriocarcinoma ? Placental site trophoblastic tumour Epithelioid trophoblastic tumour

hPL = human placental lactogen.

Notes:

  • Keratin is positive in all trophoblastic tissue and negative in decidual tissue.[3]

Chorionic villi

Chorionic villi 101

  • Maternal blood is around villi.
  • Fetal blood (nucleated (fetal) RBCs) in the villi.

Basic histology

  • Outer layer of villus / closer to mother : syncytiotrophoblasts.
  • Inner layer of villus / closer to fetus : cytotrophoblasts.
  • Stroma of villi has macrophages AKA Hofbauer cells.[6]

Chorionic villi 102

  • Syncytiotrophoblasts (eosinophilic cytoplasm with vacuoles (contain hCG), multiple hyperchromatic nuclei).
    • Large + many irreg. or lobular hyperchromatic nuclei.
    • Eosinophilic vacuolated cytoplasm (contains hCG).
    • Closest to mom - covers cytotrophoblast.[7]
  • Cytotrophoblasts (polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus).
    • Polygonal shaped cells in cords/masses.
    • Distinct cell borders.
    • Covered by syncytiobrophoblast[8] - closer to fetus than syncytiotrophoblasts.
    • Clear cytoplasm.
    • Single uniform nucleus.

Age of villi

Young villi

Old villi

  • Blood vessels present and at the periphery of villus - contain nucleated (fetal) RBCs.
  • Syncytial knots.

Villi and age - table

Gestational age Nucleated RBCs Cytotrophoblast /
syncytiotrophoblast 		Villi size Vessels Other
First trimester present both can be identified large few; location central
Second trimester rare cytotrophoblast difficult to identify; syncytial knots uncommon intermediate intermediate; location: central/periphery
Third trimester absent cytotrophoblast indistinct; syncytial knots common small abundant; location: periphery of villi focal calcifications

Intermediate trophoblast

General

  • Abbreviated: IT.

Subtypes

Three subtypes of IT are recognized:[1]

  1. Implanation site IT.
  2. Villous IT.
  3. Chorionic-type IT.

Microscopic

Features:

  • Large cells.
  • Eosinophilic cytoplasm.
    • May be multi-nucleated.

Images:

IHC

Features:[3]

  • hPL (human placental lactogen) +ve.
  • beta-hCG -ve.
  • Keratin +ve.
  • EMA +ve in 2nd & 3rd trimester.
  • CD146 +ve.[9]

Notes:

  • Cytotrophoblast and syncytiotrophoblast - keratin +ve.[3]

See also

References

  1. ↑ 1.0 1.1 1.2 Shih IM, Kurman RJ (January 2001). "The pathology of intermediate trophoblastic tumors and tumor-like lesions". Int. J. Gynecol. Pathol. 20 (1): 31–47. PMID 11192071.
  2. ↑ Kovalevskaya, G.; Genbacev, O.; Fisher, SJ.; Caceres, E.; O'Connor, JF. (Aug 2002). "Trophoblast origin of hCG isoforms: cytotrophoblasts are the primary source of choriocarcinoma-like hCG.". Mol Cell Endocrinol 194 (1-2): 147-55. PMID 12242037.
  3. ↑ 3.0 3.1 3.2 3.3 Yeh IT, O'Connor DM, Kurman RJ (May 1990). "Intermediate trophoblast: further immunocytochemical characterization". Mod. Pathol. 3 (3): 282–7. PMID 1694585.
  4. ↑ Shih, IM. (Sep 1999). "The role of CD146 (Mel-CAM) in biology and pathology.". J Pathol 189 (1): 4-11. doi:10.1002/(SICI)1096-9896(199909)189:14::AID-PATH3323.0.CO;2-P. PMID 10451481.
  5. ↑ 5.0 5.1 URL: http://pathology2.jhu.edu/trophoblast/introduction.cfm. Accessed on: 13 August 2011.
  6. ↑ Tang, Z.; Abrahams, VM.; Mor, G.; Guller, S. (Mar 2011). "Placental Hofbauer cells and complications of pregnancy.". Ann N Y Acad Sci 1221: 103-8. doi:10.1111/j.1749-6632.2010.05932.x. PMID 21401637.
  7. ↑ http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png
  8. ↑ http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png
  9. ↑ URL: http://www.epitomics.com/diagnostics/product/5618. Accessed on: 14 August 2011.

External links

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