Difference between revisions of "Placental site nodule"

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#redirect [[Gestational_trophoblastic_disease#Placental_site_nodule]]
'''Placental site nodule''' is a benign remnant of a [[placenta]]. It is seen on [[endometrium|endometrial]] biopsies and hysterectomy specimens.
==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.
 
===Images===
<gallery>
Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC)
Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC)
</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]].
 
==References==
{{Reflist|2}}
 


[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 23:14, 20 March 2014

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

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:

Images

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