Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2023 Jan-Mar;66(1):148-151. doi: 10.4103/ijpm.ijpm_212_22.
An epithelioid trophoblastic tumor (ETT) is an extremely rare gestational trophoblastic tumor. Cases of ETT present with abnormal vaginal bleeding in women of reproductive age group with marginally elevated beta human chorionic gonadotrophin (B-hCG) levels. Here, we describe a series of four patients (all were females) including histomorphology, immunoprofiles, and diagnostic difficulty of this rare entity. All cases were in their reproductive age group. The mean pre-treatment hCG level was 665.24 (mIU/mL). Microscopically, all cases had a tumor showing an epithelioid appearance arranged in large nests and sheets. Individual tumor cells were round to polygonal with abundant eosinophilic cytoplasm, with central vesicular nuclei and prominent nucleoli. Areas of hemorrhage, necrosis, and intercellular hyaline-like material deposition were identified in all cases (100%). Immunohistochemically, tumor cells in all cases showed diffuse positivity for AE1/AE3 and p63 (100%). GATA3 was available in one case (25%), which was positive in the tumor cells. In one case (25%), hPL was focally positive, and in one case (25%), it was negative. SALL4 was performed in two cases (50%) and was negative in tumor cells. The mean Ki67 labeling index was 19.2 (range 10-30%). All four patients underwent surgical intervention and were treated with hysterectomy. The mean follow-up in this series was 39.4 months (range 6-70), and all patients are alive to date with a mean survival of 32.8 months (range, 4-67).
滋养细胞上皮样肿瘤（ETT）是一种极为罕见的妊娠滋养细胞肿瘤。ETT 病例表现为育龄期妇女出现异常阴道出血，人绒毛膜促性腺激素β亚单位（β-hCG）水平轻度升高。在此，我们描述了一系列 4 例患者（均为女性），包括该罕见实体的组织形态学、免疫表型和诊断难点。所有病例均处于育龄期。治疗前 hCG 平均水平为 665.24（mIU/mL）。显微镜下，所有病例的肿瘤均呈上皮样外观，呈大巢状和片状排列。单个肿瘤细胞呈圆形至多边形，胞质丰富嗜酸性，核中央有泡状，核仁明显。所有病例均存在出血、坏死和细胞间玻璃样物质沉积（100%）。免疫组化染色显示，所有病例的肿瘤细胞均弥漫表达 AE1/AE3 和 p63（100%）。GATA3 在 1 例（25%）中可用，在肿瘤细胞中呈阳性。在 1 例（25%）中，hPL 局灶性阳性，在 1 例（25%）中，hPL 阴性。SALL4 在 2 例（50%）中进行，肿瘤细胞阴性。Ki67 标记指数平均为 19.2（范围 10-30%）。所有 4 例患者均接受手术干预，并接受子宫切除术。本系列的平均随访时间为 39.4 个月（范围 6-70），截至目前，所有患者均存活，平均生存时间为 32.8 个月（范围，4-67）。
