Kashimura M, Kashimura Y, Oikawa K, Sakamoto C, Matsuura Y, Nakamura S
Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Gynecol Oncol. 1990 Aug;38(2):262-7. doi: 10.1016/0090-8258(90)90052-m.
A rare case of placentae site trophoblastic tumor (PSTT) studied by immunohistochemistry and nuclear DNA analysis is reported. The patient, a 24-year-old Japanese female, complained of amenorrhea. Dilatation and curettage revealed a small specimen that contained trophoblastic cells and caused intractable bleeding. Pelvic sonography revealed a 5-cm mass in the posterior uterine wall with multiple cystic lesions of several sizes. The cystic lesions were shown to be dilated vessels by magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). Serum beta-hCG (beta subunit of human chorionic gonadotropin) was 3.7 ng/ml. Total abdominal hysterectomy revealed a well-circumscribed, yellow, soft mass in the posterior uterine wall. Microscopic findings were consistent with PSTT and the mitotic count was extremely low. Immunohistochemically, most of the tumor cells were intensely stained with human placental lactogen, whereas few were stained with human chorionic gonadotropin. The nuclear DNA content of the trophoblastic cells showed a sharp peak at the triploid range coexistent with a few cells of higher ploidy. This is the first report of sonographic findings and nuclear DNA analysis by spot cytometry in a case of PSTT.
报告了一例通过免疫组织化学和核DNA分析研究的胎盘部位滋养细胞肿瘤（PSTT）罕见病例。患者为一名24岁的日本女性，主诉闭经。刮宫术取出的小标本中含有滋养细胞，并导致难以控制的出血。盆腔超声检查显示子宫后壁有一个5厘米的肿块，伴有多个大小不一的囊性病变。磁共振成像（MRI）和数字减影血管造影（DSA）显示这些囊性病变为扩张的血管。血清β - 人绒毛膜促性腺激素（β - hCG）为3.7 ng/ml。全腹子宫切除术显示子宫后壁有一个边界清楚、黄色、柔软的肿块。显微镜检查结果与PSTT一致，有丝分裂计数极低。免疫组织化学显示，大多数肿瘤细胞被人胎盘催乳素强烈染色，而很少被人绒毛膜促性腺激素染色。滋养细胞的核DNA含量在三倍体范围内显示出一个尖锐的峰值，同时存在一些更高倍体的细胞。这是第一例关于PSTT病例的超声检查结果和通过流式细胞术进行核DNA分析的报告。
