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{{ 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]] |
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