Difference between revisions of "Trophoblast"

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Trophoblast (view source)

Revision as of 15:44, 15 August 2011

70 bytes added ,  15:44, 15 August 2011
rename, re-order, subdivide -- clean-up
m (moved Chorionic villi to Trophoblast: more inclusive... article changed)
(rename, re-order, subdivide -- clean-up)
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'''Chorionic villi''' are part of a normal [[pregnancy]].  They are derived from the conceptus, i.e. NOT maternal.  
'''Trophoblast''' is part of a normal [[pregnancy]].  Trophoblasts are derived from the conceptus, i.e. '''not''' maternal.
Part of the trophoblast forms '''chorionic villi'''.


Tumours arising from the trophoblast are dealt with in ''[[gestational trophoblastic disease]]''.
Tumours arising from the trophoblast are dealt with in ''[[gestational trophoblastic disease]]''.


==Chorionic villi 101==
=Trophoblast table=
*Maternal blood is around villi.
*Fetal blood (nucleated (fetal) [[RBC]]s) in the villi.
 
===Basic histology===
*Outer layer of villus / closer to mother : syncytiotrophoblasts.
*Inner layer of villus / closer to fetus : cytotrophoblasts.
 
==Chorionic villi 102==
*Syncytiotrophoblasts (eosinophilic cytoplasm with vacuoles (contain hCG), multiple hyperchromatic nuclei).
**Large + many irreg. or lobular hyperchromatic nuclei.
**Eosinophilic vacuolated cytoplasm (contains hCG).
**Closest to mom - covers cytotrophoblast.<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref>
*Cytotrophoblasts (polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus).
**Polygonal shaped cells in cords/masses.
**Distinct cell borders.
**Covered by syncytiobrophoblast<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref> - closer to fetus than syncytiotrophoblasts.
**Clear cytoplasm.
**Single uniform nucleus.
 
==Intermediate trophoblast==
===General===
*Abbreviated: ''IT''.
 
*Thought to be the cell of origin for:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
**[[Exaggerated placental site]] (EPS).
**[[Placental site nodule]] (PSN).
**[[Placental site trophoblastic tumour]] (PSTT).
**[[Epithelioid trophoblastic tumour]] (ETT).
 
===Subtypes===
Three subtypes of IT are recognized:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
#Implanation site IT.
#Villous IT.
#Chorionic-type IT.
 
===Microscopic===
Features:
*Large cells.
*Eosinophilic cytoplasm.
**May be multi-nucleated.
 
Images:
*[http://pathology2.jhu.edu/trophoblast/introduction.cfm IT - high mag. (jhu.edu)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg IT - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_lmwk_-_high_mag.jpg IT - LMWK - high mag. (WC)].
 
====IHC====
Features:<ref name=pmid1694585>{{cite journal |author=Yeh IT, O'Connor DM, Kurman RJ |title=Intermediate trophoblast: further immunocytochemical characterization |journal=Mod. Pathol. |volume=3 |issue=3 |pages=282–7 |year=1990 |month=May |pmid=1694585 |doi= |url=}}</ref>
*hPL (human placental lactogen) +ve.
*beta-hCG -ve.
*Keratin +ve.
*EMA +ve in 2nd & 3rd trimester.
*CD146 +ve.<ref>URL: [http://www.epitomics.com/diagnostics/product/5618 http://www.epitomics.com/diagnostics/product/5618]. Accessed on: 14 August 2011.</ref>
 
Notes:
*Cytotrophoblast and syncytiotrophoblast - keratin +ve.<ref name=pmid1694585/>
 
==Age of villi==
===Young villi===
*Do not have [[blood vessel]]s.
*No syncytial knots.
 
===Old villi===
*Blood vessels present and at the periphery of villus - contain nucleated (fetal) RBCs.
*Syncytial knots.
 
==Trophoblast table==
Based on Shih ''et al.'':<ref name=pmid11192071/>
Based on Shih ''et al.'':<ref name=pmid11192071/>
{| class="wikitable"
{| class="wikitable"
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Notes:
Notes:
*Keratin is positive in all trophoblastic tissue and negative in decidual tissue.<ref name=pmid1694585/>
*Keratin is positive in all trophoblastic tissue and negative in decidual tissue.<ref name=pmid1694585/>
=Chorionic villi=
==Chorionic villi 101==
*Maternal blood is around villi.
*Fetal blood (nucleated (fetal) [[RBC]]s) in the villi.
===Basic histology===
*Outer layer of villus / closer to mother : syncytiotrophoblasts.
*Inner layer of villus / closer to fetus : cytotrophoblasts.
==Chorionic villi 102==
*Syncytiotrophoblasts (eosinophilic cytoplasm with vacuoles (contain hCG), multiple hyperchromatic nuclei).
**Large + many irreg. or lobular hyperchromatic nuclei.
**Eosinophilic vacuolated cytoplasm (contains hCG).
**Closest to mom - covers cytotrophoblast.<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref>
*Cytotrophoblasts (polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus).
**Polygonal shaped cells in cords/masses.
**Distinct cell borders.
**Covered by syncytiobrophoblast<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref> - closer to fetus than syncytiotrophoblasts.
**Clear cytoplasm.
**Single uniform nucleus.
==Age of villi==
===Young villi===
*Do not have [[blood vessel]]s.
*No syncytial knots.
===Old villi===
*Blood vessels present and at the periphery of villus - contain nucleated (fetal) RBCs.
*Syncytial knots.


==Villi and age - table==
==Villi and age - table==
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|}
|}


==See also==
=Intermediate trophoblast=
===General===
*Abbreviated: ''IT''.
 
*Thought to be the cell of origin for:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
**[[Exaggerated placental site]] (EPS).
**[[Placental site nodule]] (PSN).
**[[Placental site trophoblastic tumour]] (PSTT).
**[[Epithelioid trophoblastic tumour]] (ETT).
 
===Subtypes===
Three subtypes of IT are recognized:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref>
#Implanation site IT.
#Villous IT.
#Chorionic-type IT.
 
===Microscopic===
Features:
*Large cells.
*Eosinophilic cytoplasm.
**May be multi-nucleated.
 
Images:
*[http://pathology2.jhu.edu/trophoblast/introduction.cfm IT - high mag. (jhu.edu)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg IT - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_lmwk_-_high_mag.jpg IT - LMWK - high mag. (WC)].
 
====IHC====
Features:<ref name=pmid1694585>{{cite journal |author=Yeh IT, O'Connor DM, Kurman RJ |title=Intermediate trophoblast: further immunocytochemical characterization |journal=Mod. Pathol. |volume=3 |issue=3 |pages=282–7 |year=1990 |month=May |pmid=1694585 |doi= |url=}}</ref>
*hPL (human placental lactogen) +ve.
*beta-hCG -ve.
*Keratin +ve.
*EMA +ve in 2nd & 3rd trimester.
*CD146 +ve.<ref>URL: [http://www.epitomics.com/diagnostics/product/5618 http://www.epitomics.com/diagnostics/product/5618]. Accessed on: 14 August 2011.</ref>
 
Notes:
*Cytotrophoblast and syncytiotrophoblast - keratin +ve.<ref name=pmid1694585/>
 
=See also=
*[[Endometrium]].
*[[Endometrium]].
*[[Products of conception]].
*[[Products of conception]].
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*[[Arias-Stella reaction]] - benign atypical changes associated with chorionic tissue.
*[[Arias-Stella reaction]] - benign atypical changes associated with chorionic tissue.


==References==
=References=
{{reflist|2}}
{{reflist|2}}


[[Category:Gynecologic pathology]]
[[Category:Gynecologic pathology]]


==External links==
=External links=
*[http://www.med.yale.edu/obgyn/kliman/placenta/articles/AJP%20Commentary.html Uteroplacental Blood Flow: The Story of Decidualization, Menstruation and Trophoblast Invasion (yale.edu)].
*[http://www.med.yale.edu/obgyn/kliman/placenta/articles/AJP%20Commentary.html Uteroplacental Blood Flow: The Story of Decidualization, Menstruation and Trophoblast Invasion (yale.edu)].
Michael
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