Difference between revisions of "Trophoblast"

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Trophoblast (view source)

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| '''Syncytiotrophoblast'''
| '''Syncytiotrophoblast'''
| '''Villous intermediate<br>trophoblast'''
| '''Villous intermediate<br>trophoblast'''
| '''Implanation site<br>intermediate trophoblast'''
| '''Implantation site<br>intermediate trophoblast'''
| '''Chorionic-type<br>intermediate trophoblast'''
| '''Chorionic-type<br>intermediate trophoblast'''
|-
|-
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| Cytoplasm
| Cytoplasm
| minimal, clear to granular
| minimal, clear to granular
| abundant, vacuolated
| abundant, vacuolated, basophilic (???)
| abundant & eosinophilic to clear
| abundant & eosinophilic to clear
| abundant & eosinophilic
| abundant & eosinophilic
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|-
|-
| IHC
| IHC
| beta-hCG ???
| beta-hCG -ve (???), p63 +ve<ref name=pmid19188816>{{Cite journal  | last1 = Zhang | first1 = HJ. | last2 = Xue | first2 = WC. | last3 = Siu | first3 = MK. | last4 = Liao | first4 = XY. | last5 = Ngan | first5 = HY. | last6 = Cheung | first6 = AN. | title = P63 expression in gestational trophoblastic disease: correlation with proliferation and apoptotic dynamics. | journal = Int J Gynecol Pathol | volume = 28 | issue = 2 | pages = 172-8 | month = Mar | year = 2009 | doi = 10.1097/PGP.0b013e318189555b | PMID = 19188816 }}</ref>
| beta-hCG
| beta-hCG +ve
| ???
| p63 +ve,<ref name=pmid19188816/> PLAP +ve
| 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 +ve, hPL +ve, beta-hCG -ve<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 -ve
| ???
| hPL +ve/-ve, p63 +ve, CD146 -ve
|-
|-
| Image
| Image
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| [http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg (WC)]
| [http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg (WC)]
|
|
|-
| Associated tumour
| [[Choriocarcinoma]]
| Choriocarcinoma
| ?
| [[Placental site trophoblastic tumour]]
| [[Epithelioid trophoblastic tumour]]
|-
|}
|}
hPL = human placental lactogen.
hPL = human placental lactogen.
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===Basic histology===
===Basic histology===
*Outer layer of villus / closer to mother : syncytiotrophoblasts.
*Syncytiotrophoblasts: outer layer of villus / closer to mother.
*Inner layer of villus / closer to fetus : cytotrophoblasts.
*Cytotrophoblasts: inner layer of villus / closer to fetus.
*Stroma of villi has macrophages ''AKA'' Hofbauer cells.<ref name=pmid21401637>{{Cite journal  | last1 = Tang | first1 = Z. | last2 = Abrahams | first2 = VM. | last3 = Mor | first3 = G. | last4 = Guller | first4 = S. | title = Placental Hofbauer cells and complications of pregnancy. | journal = Ann N Y Acad Sci | volume = 1221 | issue =  | pages = 103-8 | month = Mar | year = 2011 | doi = 10.1111/j.1749-6632.2010.05932.x | PMID = 21401637 }}</ref>
*Hofbauer cells: cells in the stroma of the villi, abundant bubbly cytoplasm - villus macrophages.<ref name=pmid21401637>{{Cite journal  | last1 = Tang | first1 = Z. | last2 = Abrahams | first2 = VM. | last3 = Mor | first3 = G. | last4 = Guller | first4 = S. | title = Placental Hofbauer cells and complications of pregnancy. | journal = Ann N Y Acad Sci | volume = 1221 | issue =  | pages = 103-8 | month = Mar | year = 2011 | doi = 10.1111/j.1749-6632.2010.05932.x | PMID = 21401637 }}</ref>
 
====Images====
<gallery>
Image: Chorionic villi - low mag.jpg | Chorionic villi - low mag. (WC)
Image: Chorionic villi - intermed mag.jpg | Chorionic villi - intermed. mag. (WC)
Image: Chorionic villi - high mag.jpg | Chorionic villi - high mag. (WC)
Image: Chorionic villi - very high mag.jpg | Chorionic villi - very high mag. - image has numerous annotations. (WC)
</gallery>
www:
*[http://courseweb.edteched.uottawa.ca/medicine-histology/english/reproduction/Placenta/Fig08Placenta.htm Placental villi - histology (uottawa.ca)].


==Chorionic villi 102==
==Chorionic villi 102==
*Syncytiotrophoblasts (eosinophilic cytoplasm with vacuoles (contain hCG), multiple hyperchromatic nuclei).
===Syncytiotrophoblasts===
*Multiple hyperchromatic nuclei, eosinophilic cytoplasm with vacuoles (contain hCG).
**Large + many irreg. or lobular hyperchromatic nuclei.  
**Large + many irreg. or lobular hyperchromatic nuclei.  
**Eosinophilic vacuolated cytoplasm (contains hCG).
**Eosinophilic vacuolated cytoplasm (contains hCG).
**Closest to mom - covers cytotrophoblast.<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref>
**Closest to mom - covers cytotrophoblast.<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref>
*Cytotrophoblasts (polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus).
 
Note:
*Syncytiotrophoblasts arise from cytotrophoblasts.<ref name=pmid24595308>{{Cite journal  | last1 = Díaz | first1 = P. | last2 = Wood | first2 = AM. | last3 = Sibley | first3 = CP. | last4 = Greenwood | first4 = SL. | title = Intermediate conductance Ca2+-activated K+ channels modulate human placental trophoblast syncytialization. | journal = PLoS One | volume = 9 | issue = 3 | pages = e90961 | month =  | year = 2014 | doi = 10.1371/journal.pone.0090961 | PMID = 24595308 }}</ref>
 
====Images====
<gallery>
Image: Seminoma with syncytiotrophoblasts -- low mag.jpg | Syncytiotrophoblasts in seminoma - low mag.
Image: Seminoma with syncytiotrophoblasts -- intermed mag.jpg | Syncytiotrophoblasts in seminoma - intermed. mag.
Image: Seminoma with syncytiotrophoblasts -- high mag.jpg | Syncytiotrophoblasts in seminoma - high mag.
Image: Seminoma with syncytiotrophoblasts -- very high mag.jpg | Syncytiotrophoblasts in seminoma - very high mag.
</gallery>
 
===Cytotrophoblasts===
*Polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus.
**Polygonal shaped cells in cords/masses.
**Polygonal shaped cells in cords/masses.
**Distinct cell borders.
**Distinct cell borders.
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==Age of villi==
==Age of villi==
===Young villi===
===Young villi===
*Do not have [[blood vessel]]s.
*Few [[blood vessel]]s, central location.
*No syncytial knots.
*Few syncytial knots.


===Old villi===
===Old villi===
*Blood vessels present and at the periphery of villus - contain nucleated (fetal) RBCs.
*Blood vessels present and at the periphery of villi.
*Syncytial knots.
*Syncytial knots.


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| '''Other'''
| '''Other'''
|-
|-
| First trimester
| First trimester (<13 weeks<ref name=pmid22712058>{{Cite journal  | last1 = Haggerty | first1 = CL. | last2 = Seifert | first2 = ME. | last3 = Tang | first3 = G. | last4 = Olsen | first4 = J. | last5 = Bass | first5 = DC. | last6 = Karumanchi | first6 = SA. | last7 = Ness | first7 = RB. | title = Second trimester anti-angiogenic proteins and preeclampsia. | journal = Pregnancy Hypertens | volume = 2 | issue = 2 | pages = 158-163 | month = Apr | year = 2012 | doi = 10.1016/j.preghy.2012.01.005 | PMID = 22712058 }}</ref>)
| present
| present
| both can be identified
| both can be identified
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|
|
|-
|-
| Second trimester
| Second trimester (>=13 weeks and <28 weeks<ref name=pmid22146095>{{Cite journal  | last1 = Grewal | first1 = E. | last2 = Kansara | first2 = S. | last3 = Kachhawa | first3 = G. | last4 = Ammini | first4 = AC. | last5 = Kriplani | first5 = A. | last6 = Aggarwal | first6 = N. | last7 = Gupta | first7 = N. | last8 = Khadgawat | first8 = R. | title = Prediction of gestational diabetes mellitus at 24 to 28 weeks of gestation by using first-trimester insulin sensitivity indices in Asian Indian subjects. | journal = Metabolism | volume = 61 | issue = 5 | pages = 715-20 | month = May | year = 2012 | doi = 10.1016/j.metabol.2011.10.009 | PMID = 22146095 }}</ref>)
| rare
| rare
| cytotrophoblast difficult to identify; syncytial knots uncommon
| cytotrophoblast difficult to identify; syncytial knots uncommon
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| focal calcifications
| focal calcifications
|}
|}
Notes:
*The villi size is not very helpful in differentiating second and trimester placentas.


=Intermediate trophoblast=
=Intermediate trophoblast=
*Abbreviated: ''IT''.
===General===
===General===
*Abbreviated: ''IT''.
*Thought to be the cell of origin for:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
*Thought to be the cell of origin for:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
**[[Exaggerated placental site]] (EPS).
**[[Exaggerated placental site]] (EPS).
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**May be multi-nucleated.
**May be multi-nucleated.


Images:
====Images====
<gallery>
Image:Intermediate trophoblast - intermed mag.jpg | IT - intermed. mag. (WC/Nephron)
Image:Intermediate trophoblast 2 - intermed mag.jpg | IT - intermed. mag. (WC/Nephron)
Image:Intermediate_trophoblast_-_high_mag.jpg | IT - high mag. (WC/Nephron)
Image:Intermediate_trophoblast_-_lmwk_-_high_mag.jpg | IT - LMWK - high mag. (WC/Nephron)
</gallery>
www:
*[http://pathology2.jhu.edu/trophoblast/introduction.cfm IT - high mag. (jhu.edu)].
*[http://pathology2.jhu.edu/trophoblast/introduction.cfm IT - high mag. (jhu.edu)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg IT - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_lmwk_-_high_mag.jpg IT - LMWK - high mag. (WC)].


====IHC====
====IHC====
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*beta-hCG -ve.
*beta-hCG -ve.
*Keratin +ve.
*Keratin +ve.
*EMA +ve in 2nd & 3rd trimester.
**[[CK7]] +ve.<ref name=pmid19069710>{{Cite journal  | last1 = Trenkić | first1 = M. | last2 = Basić | first2 = M. | last3 = Milentijević | first3 = M. | last4 = Petrović | first4 = A. | last5 = Zivković | first5 = V. | last6 = Lazarević | first6 = V. | title = Immunohistohemical evidences of pregnancy in uterine curettage tissue by the use of a double immunocytochemical staining technique using cytokeratin 7 and vimentin antibodies. | journal = Vojnosanit Pregl | volume = 65 | issue = 11 | pages = 810-3 | month = Nov | year = 2008 | doi =  | PMID = 19069710 }}
</ref>
*[[EMA]] +ve in 2nd & 3rd trimester.
*CD146 +ve.<ref>URL: [http://www.epitomics.com/diagnostics/product/5618 http://www.epitomics.com/diagnostics/product/5618]. Accessed on: 14 August 2011.</ref>
*CD146 +ve.<ref>URL: [http://www.epitomics.com/diagnostics/product/5618 http://www.epitomics.com/diagnostics/product/5618]. Accessed on: 14 August 2011.</ref>


Michael
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