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微小葡萄胎的临床与病理研究

Clinical and pathological investigation of microscopic mole.

作者信息

Ito K

机构信息

Department of Obstetrics and Gynecology, Kinki University School of Medicine, Osaka-Sayama, Japan.

出版信息

Tohoku J Exp Med. 1993 Apr;169(4):309-17. doi: 10.1620/tjem.169.309.

Abstract

To clarify the pathological significance of the quasi-mole lesions of the placenta, morphological and morphometrical study of villi was undertaken. The material comprised products of conception in 70 cases of artificial abortion, 110 cases of spontaneous abortion and 11 cases of complete mole: The artificially aborted material was regarded as having normal villi. The products, after being observed with a stereo microscope, were subjected to microscopic examination of paraffin sections. A vascular villi with central liquefaction and proliferation of trophoblasts were found not only in the group of overt mole but also in spontaneously aborted and even in artificially aborted material, though less frequently. By morphometry, villi were shown to be involved in these changes even when macroscopically there seemed to be no significant abnormalities, a condition we prefer to call "microscopic mole." This was prevailing particularly in cases in which the average minor axis of villi exceeded 1 mm; it became more predominant with enlarging axis, gradually approaching the shape of complete mole. Some of the cases with enlarged villi proved to develop later invasive mole. Thus, whether or not the average minor axis exceeds 1 mm is likely to have a profound clinical significance.

摘要

为阐明胎盘准葡萄胎病变的病理意义,对绒毛进行了形态学和形态计量学研究。材料包括70例人工流产、110例自然流产和11例完全性葡萄胎的妊娠产物:人工流产材料被视为具有正常绒毛。这些产物经立体显微镜观察后,进行石蜡切片的显微镜检查。不仅在显性葡萄胎组,而且在自然流产甚至人工流产材料中都发现了伴有中央液化和滋养层细胞增生的血管绒毛,不过出现频率较低。通过形态计量学发现,即使宏观上似乎没有明显异常,绒毛也参与了这些变化,我们倾向于将这种情况称为“微小葡萄胎”。这在绒毛平均短轴超过1毫米的病例中尤为普遍;随着短轴增大,这种情况变得更加明显,逐渐接近完全性葡萄胎的形态。一些绒毛增大的病例后来发展为侵袭性葡萄胎。因此,平均短轴是否超过1毫米可能具有深远的临床意义。

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