Department of Surgical Pathology, the Affiliated Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, P.R. China.
Int J Gynecol Pathol. 2012 Sep;31(5):458-62. doi: 10.1097/PGP.0b013e31824a1dc9.
We report 2 unusual cases of gestational trophoblastic disease from chorionic-type intermediate trophoblastic cells after a Cesarean section. A 32-year-old woman presented with a 2-year history of vaginal bleeding, while a 41-year-old woman presented with a pelvic mass. Both patients had cystic lesions with a fistula formation beneath their Cesarean scars in the anterior uterine isthmus. Microscopically, both lesions were lined with multiple layers of intermediate trophoblastic cells without penetration into the surrounding myometrium, endometrium, or blood vessels. The trophoblastic cells were generally bland. However, a subset of trophoblastic cells showed large, hyperchromatic nuclei in some areas. The trophoblastic cells were p63 positive and human placental lactogen negative. The Ki67 indexes were 12.7% and 8.6%, respectively. We propose their description as atypical epithelioid trophoblastic lesions with cyst and fistula formation after a Cesarean section.
我们报告了 2 例罕见的剖宫产术后绒毛膜型中间型滋养细胞肿瘤。1 例 32 岁女性因阴道出血 2 年就诊，1 例 41 岁女性因盆腔包块就诊。两名患者的剖宫产瘢痕前子宫峡部均有囊性病变，伴有瘘管形成。镜下，两处病变均由多层中间型滋养细胞衬覆，无穿透周围的子宫肌层、子宫内膜或血管。滋养细胞通常为温和型。然而，在一些区域，部分滋养细胞显示出大而深染的核。滋养细胞 p63 阳性，人胎盘催乳素阴性。Ki67 指数分别为 12.7%和 8.6%。我们建议将其描述为剖宫产术后伴囊肿和瘘管形成的非典型上皮样滋养细胞病变。
