Difference between revisions of "Placental site nodule"

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'''Placental site nodule''' is a benign remnant of a [[placenta]]. It is seen on [[endometrium|endometrial]] biopsies and hysterectomy specimens.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Placental site nodule -- very high mag.jpg
| Width      =
| Caption    = Placental site nodule. [[H&E stain]].
| Synonyms  =
| Micro      = paucicellular hyaline material scattered cells (variable cell population: small to large cells with clear to eosinophilic cytoplasm), +/-multinucleation, no mitotic activity
| Subtypes  =
| LMDDx      = invasive [[cervical squamous cell carcinoma]], [[exaggerated placental site]], fibrin +/-inflammatory cells
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[endometrium]]
| Assdx      =
| Syndromes  =
| Clinicalhx = previously pregnant
| Signs      =
| Symptoms  = none
| Prevalence = common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        = none
}}
'''Placental site nodule''', abbreviated '''PSN''', is a benign remnant of a [[placenta]]. It is seen on [[endometrium|endometrial]] biopsies and hysterectomy specimens.
 
'''Implantation site''' redirects here.
==General==
==General==
*Benign.
*Benign.
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*[[Exaggerated placental site]].
*[[Exaggerated placental site]].
**Different histomorphology than PSN; EPS:<ref name=pmid19332926/> syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules.
**Different histomorphology than PSN; EPS:<ref name=pmid19332926/> syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules.
*Fibrin +/-inflammatory cells.


===Images===
===Images===
====Case 1====
<gallery>
<gallery>
Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC)
Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC)
Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC)
Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC)
</gallery>
</gallery>
www:
====Case 2====
<gallery>
Image: Placental site nodule -- low mag.jpg | PSN - low mag.
Image: Placental site nodule -- intermed mag.jpg | PSN - intermed. mag.
Image: Placental site nodule -- high mag.jpg | PSN - high mag.
Image: Placental site nodule -- very high mag.jpg | PSN - very high mag.
</gallery>
====www====
*[http://www.ijpmonline.org/viewimage.asp?img=IndianJPatholMicrobiol_2009_52_2_240_48931_u4.jpg PSN (ijpmonline.org)].<ref name=pmid19332926/>
*[http://www.ijpmonline.org/viewimage.asp?img=IndianJPatholMicrobiol_2009_52_2_240_48931_u4.jpg PSN (ijpmonline.org)].<ref name=pmid19332926/>
*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=12&cat3=1256&stype=d PSN (gfmer.ch)] - includes images from ''Jacob and Mohapatra''.<ref name=pmid19332926/>
*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=12&cat3=1256&stype=d PSN (gfmer.ch)] - includes images from ''Jacob and Mohapatra''.<ref name=pmid19332926/>
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==See also==
==See also==
*[[Gestational trophoblastic disease]].
*[[Gestational trophoblastic disease]].
*[[Endometrium]].


==References==
==References==
{{Reflist|2}}
{{Reflist|1}}
 


[[Category:Gestational trophoblastic disease]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Endometrium]]

Latest revision as of 04:27, 13 May 2016

Placental site nodule
Diagnosis in short

Placental site nodule. H&E stain.
LM paucicellular hyaline material scattered cells (variable cell population: small to large cells with clear to eosinophilic cytoplasm), +/-multinucleation, no mitotic activity
LM DDx invasive cervical squamous cell carcinoma, exaggerated placental site, fibrin +/-inflammatory cells
Site endometrium
Clinical history previously pregnant
Symptoms none
Prevalence common
Prognosis benign
Treatment none

Placental site nodule, abbreviated PSN, is a benign remnant of a placenta. It is seen on endometrial biopsies and hysterectomy specimens.

Implantation site redirects here.

General

  • Benign.
  • Intermediate trophoblast remnants from a previous gestation.[1]
  • Usually an incidental finding.

Clinical:

  • Usually asymptomatic.
  • Vaginal bleeding. (?)
  • Infertility. (?)

Microscopic

Features:[1]

  • Paucicellular with hyaline material scattered cells.
  • Variable cell population:
    • Small-large cells.
    • Clear to eosinophilic cytoplasm.
    • +/-Multinucleation.

Notes:

  • No mitotic activity.

DDx:

  • Invasive (cervical) squamous cell carcinoma.
    • Can be sorted-out with IHC (SCC will typically be: p16 +ve, MIB1 +ve).
  • Exaggerated placental site.
    • Different histomorphology than PSN; EPS:[1] syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules.
  • Fibrin +/-inflammatory cells.

Images

Case 1

  • PSN - intermed. mag. (WC)

  • PSN - high mag. (WC)

Case 2

  • PSN - low mag.

  • PSN - intermed. mag.

  • PSN - high mag.

  • PSN - very high mag.

www

IHC

Features:[1]

  • Inhibin alpha +ve.
  • CK18 +ve.
  • MIB1 low.

Other:

  • p16 -ve.

Sign out

- CONSISTENT WITH MENSTRUAL ENDOMETRIUM (FRAGMENTED ENDOMETRIUM WITH SIMPLE
  GLANDS WITH APOPTOTIC CELLS, ABUNDANT NEUTROPHILS, CONDENSED ENDOMETRIAL STROMA
  (FOCAL) AND BLOOD).
- PLACENTAL SITE NODULE AND DECIDUA.
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

ENDOMETRIUM, BIOPSY:
- PROLIFERATIVE PHASE ENDOMETRIUM.
- BENIGN PLACENTAL SITE NODULE, SMALL.
- NEGATIVE FOR HYPERPLASIA.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Jacob, S.; Mohapatra, D.. "Placental site nodule: a tumor-like trophoblastic lesion.". Indian J Pathol Microbiol 52 (2): 240-1. PMID 19332926. http://www.ijpmonline.org/text.asp?2009/52/2/240/48931.
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