Eckstein R P, Paradinas F J, Bagshawe K D
Histopathology. 1982 Mar;6(2):211-26. doi: 10.1111/j.1365-2559.1982.tb02716.x.
The clinico-pathological features of four patients with placental-site trophoblastic tumour (trophoblastic pseudotumour) are presented. One patient had the nephrotic syndrome associated with evidence of disseminated intravascular coagulation, with complete resolution after hysterectomy. In two patients the tumour extended beyond the uterus, and one of them died with many metastases in spite of intensive post-operative chemotherapy and 'second look' laparotomy. In three patients the tumour behaved as an actively infiltrative neoplasm resistant to chemotherapeutic regimes usually effective for choriocarcinoma. Serum HCG levels were relatively low compared with those of choriocarcinoma. Histologically the tumours were predominantly composed of mononuclear cells supported by a variable amount of vascular stroma and lacked the bilaminar structure characteristic of choriocarcinoma. Scattered cells stained positively with anti-beta HCG and anti-alpha HCG antisera. Prior curettage was diagnostic in two of three cases. We did not find a clear correlation between mitotic activity and subsequent behaviour. Inflammatory cell infiltration and evidence of organisation around the tumour may be favourable prognostic indicators. We agree with a recent publication stressing the variable behaviour of this tumour, and emphasize the importance of serum HCG monitoring. Total surgical excision is usually feasible and in aggressive cases offers the best chance of eradication. We support the recent suggestion that 'trophoblastic pseudotumour' is an unsuitable name for a potentially lethal disease.
本文报告了4例胎盘部位滋养细胞肿瘤（滋养细胞假瘤）的临床病理特征。1例患者伴有弥散性血管内凝血证据的肾病综合征，子宫切除术后完全缓解。2例患者肿瘤超出子宫范围，其中1例尽管术后进行了强化化疗和“二次探查”剖腹术，仍死于多处转移。3例患者的肿瘤表现为对通常对绒毛膜癌有效的化疗方案耐药的侵袭性肿瘤。与绒毛膜癌相比，血清人绒毛膜促性腺激素（HCG）水平相对较低。组织学上，肿瘤主要由单核细胞组成，伴有数量不等的血管间质，缺乏绒毛膜癌特征性的双层结构。散在细胞用抗β-HCG和抗α-HCG抗血清染色呈阳性。3例中有2例刮宫术前诊断明确。我们未发现有丝分裂活性与后续行为之间存在明显相关性。肿瘤周围的炎性细胞浸润和机化证据可能是良好的预后指标。我们赞同最近一篇强调该肿瘤行为多变的文献，并强调血清HCG监测的重要性。完全手术切除通常可行，在侵袭性病例中提供了最佳的根除机会。我们支持最近的建议，即“滋养细胞假瘤”对于一种潜在致命性疾病来说是一个不合适的名称。
