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'''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]] | ||