Difference between revisions of "Placental site nodule"

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

Latest revision as of 04:27, 13 May 2016

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

PSN (ijpmonline.org).^[1]
PSN (gfmer.ch) - includes images from Jacob and Mohapatra.^[1]

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.

References

↑ ^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.

[pmid19332926-1] 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.

[1]

@@ Line 1: / Line 1: @@
-#redirect [[Gestational_trophoblastic_disease#Placental_site_nodule]]
+{{ 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==
+*Benign.
+*Intermediate trophoblast remnants from a previous gestation.<ref name=pmid19332926>{{Cite journal  | last1 = Jacob | first1 = S. | last2 = Mohapatra | first2 = D. | title = Placental site nodule: a tumor-like trophoblastic lesion. | journal = Indian J Pathol Microbiol | volume = 52 | issue = 2 | pages = 240-1 | month =  | year =  | doi =  | PMID = 19332926 | url = http://www.ijpmonline.org/text.asp?2009/52/2/240/48931 }}</ref>
+*Usually an incidental finding.
+Clinical:
+*Usually asymptomatic.
+*Vaginal bleeding. (?)
+*Infertility. (?)
+==Microscopic==
+Features:<ref name=pmid19332926/>
+*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:<ref name=pmid19332926/> syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules.
+*Fibrin +/-inflammatory cells.
+===Images===
+====Case 1====
+<gallery>
+Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC)
+Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC)
+</gallery>
+====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.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/>
+==IHC==
+Features:<ref name=pmid19332926/>
+*Inhibin alpha +ve.
+*CK18 +ve.
+*MIB1 low.
+Other:
+*p16 -ve.
+==Sign out==
+<pre>
+- 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.
+</pre>
+<pre>
+ENDOMETRIUM, BIOPSY:
+- PROLIFERATIVE PHASE ENDOMETRIUM.
+- BENIGN PLACENTAL SITE NODULE, SMALL.
+- NEGATIVE FOR HYPERPLASIA.
+</pre>
+==See also==
+*[[Gestational trophoblastic disease]].
+*[[Endometrium]].
+==References==
+{{Reflist|1}}
+[[Category:Gestational trophoblastic disease]]
+[[Category:Diagnosis]]
+[[Category:Endometrium]]

Difference between revisions of "Placental site nodule"

Latest revision as of 04:27, 13 May 2016

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