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Difference between revisions of "Gestational trophoblastic disease"
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Gestational trophoblastic disease (view source)
Revision as of 04:09, 28 December 2011
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=Entities= | =Entities= | ||
==Choriocarcinoma== | ==Choriocarcinoma== | ||
{{Main|Choriocarcinoma}} | |||
===General=== | ===General=== | ||
*Classified as a [[germ cell tumour]]. | *Classified as a [[germ cell tumour]]. | ||
*May be preceded by a complete hydatidiform mole.<ref name=Ref_PBoD1110-1>{{Ref PBoD|1110-1111}}</ref> | *May be preceded by a complete hydatidiform mole.<ref name=Ref_PBoD1110-1>{{Ref PBoD|1110-1111}}</ref> | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
*[ | *Two cell populations: | ||
* | #'''C'''ytotrophoblasts - '''key feature'''. | ||
* | #*'''C'''lear cytoplasm. | ||
#*Polygonal shaped cells in cords/masses. | |||
#*Distinct cell borders. | |||
#*Single uniform nucleus. | |||
#Syncytiotrophoblasts - may be absent.<ref>URL: [http://www.webpathology.com/image.asp?n=4&Case=36 http://www.webpathology.com/image.asp?n=4&Case=36]. Accessed on: 8 February 2011.</ref> | |||
#*Large + many irreg. or lobular hyperchromatic nuclei. | |||
#*Eosinophilic vacuolated cytoplasm (contains hCG). | |||
*+/-Hemorrhage. | |||
*+/-Necrosis. | |||
Notes: | |||
*[ | *No ''[[chorionic villi]]'' should be present. | ||
* | **If chorionic villi are present... it is likely a type of [[hydatidiform mole]]. | ||
*The dual cell population may not be evident at first. | |||
**Hemorrhage and marked nuclear pleomorphism are suggestive of the diagnosis. | |||
Images: | |||
* | *www: | ||
**[http://www.webpathology.com/image.asp?n=5&Case=36 Choriocarcinoma - low mag. (webpathology.com)]. | |||
**[http://www.webpathology.com/image.asp?case=36&n=1 Choriocarcinoma (webpathology.com)]. | |||
**[http://www.webpathology.com/image.asp?n=4&Case=36 Choriocarcinoma (webpathology.com)]. | |||
**[http://chestjournal.chestpubs.org/content/138/1/220.full Choriocarcinoma (chestjournal.chestpubs.org)].<ref>{{Cite journal | last1 = Venkatram | first1 = S. | last2 = Muppuri | first2 = S. | last3 = Niazi | first3 = M. | last4 = Fuentes | first4 = GD. | title = A 24-year-old pregnant patient with diffuse alveolar hemorrhage. | journal = Chest | volume = 138 | issue = 1 | pages = 220-3 | month = Jul | year = 2010 | doi = 10.1378/chest.09-2688 | PMID = 20605823 }}</ref> | |||
**[http://oac.med.jhmi.edu/Pathology/Repro/Placenta/279B_Full.html Choriocarcinoma - uterus (med.jhmi.edu)]. | |||
*[[WC]]: | |||
**[http://commons.wikimedia.org/wiki/File:Choriocarcinoma_-2-_high_mag.jpg Choriocarcinoma - high mag. (WC)]. | |||
**[http://commons.wikimedia.org/wiki/File:Choriocarcinoma_-2-_very_high_mag.jpg Choriocarcinoma - very high mag. (WC)]. | |||
===IHC=== | ===IHC=== | ||
*beta-hCG +ve.<ref name=pmid19145204>{{cite journal |author=Kalhor N, Ramirez PT, Deavers MT, Malpica A, Silva EG |title=Immunohistochemical studies of trophoblastic tumors |journal=Am. J. Surg. Pathol. |volume=33 |issue=4 |pages=633–8 |year=2009 |month=April |pmid=19145204 |doi=10.1097/PAS.0b013e318191f2eb |url=}}</ref> | *beta-hCG +ve.<ref name=pmid19145204>{{cite journal |author=Kalhor N, Ramirez PT, Deavers MT, Malpica A, Silva EG |title=Immunohistochemical studies of trophoblastic tumors |journal=Am. J. Surg. Pathol. |volume=33 |issue=4 |pages=633–8 |year=2009 |month=April |pmid=19145204 |doi=10.1097/PAS.0b013e318191f2eb |url=}}</ref> | ||
**Classically said to be produced by syncytiotrophoblasts.<ref name=pmid20735820>{{Cite journal | last1 = Cole | first1 = LA. | title = Biological functions of hCG and hCG-related molecules. | journal = Reprod Biol Endocrinol | volume = 8 | issue = | pages = 102 | month = | year = 2010 | doi = 10.1186/1477-7827-8-102 | PMID = 20735820 | PMC = 2936313 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936313/ }} | |||
</ref> | |||
***Cytotrophoblasts also produce some.<ref name=pmid20735820/><ref name=pmid12242037>{{Cite journal | last1 = Kovalevskaya | first1 = G. | last2 = Genbacev | first2 = O. | last3 = Fisher | first3 = SJ. | last4 = Caceres | first4 = E. | last5 = O'Connor | first5 = JF. | title = Trophoblast origin of hCG isoforms: cytotrophoblasts are the primary source of choriocarcinoma-like hCG. | journal = Mol Cell Endocrinol | volume = 194 | issue = 1-2 | pages = 147-55 | month = Aug | year = 2002 | doi = | PMID = 12242037 }}</ref> | |||
==Hydatidiform moles== | ==Hydatidiform moles== | ||