Baergen R N, Rutgers J L
Department of Pathology, University of California San Diego School of Medicine, USA.
Gen Diagn Pathol. 1997 Nov;143(2-3):143-58.
The trophoblast of the chorionic villi as well as the hydatidiform mole and choriocarcinoma have been recognized and studied for many years. However, the trophoblast comprising the implantation site, chorionic plate, chorion laeve, cell islands and septa have only in recent years received attention in the literature. These "extravillous" trophoblastic cells were originally referred to as "X" cells due to doubt regarding their derivation from either maternal or fetal tissue (70). Subsequent studies determined that they were trophoblastic in origin (42), but the term X-cell is still in use today by some researchers (30, 4). Due to continued uncertainty regarding their nature and origin, many other terms have been used including syncytial wandering cells (21), placental site trophoblast, placental site giant cells (42), extravillous trophoblast (25), extravillous cytotrophoblast, nonvillous trophoblast, and intermediate trophoblast (49). Light microscopic and immunohistochemical studies have led to elucidation of specific morphologic and biochemical features of the extravillous trophoblast (48-50) which is commonly designated as the "intermediate trophoblast". Lesions of the "intermediate" or extravillous trophoblast of the placental site include the exaggerated placental site, the placental site trophoblast tumor and the recently described placental site nodule. This article will review the clinical and pathologic features of these lesions, their differential diagnosis, treatment, and prognostic factors after discussion of the origin, nature and definition of the "intermediate" trophoblast.
多年来，人们一直对绒毛膜绒毛的滋养层以及葡萄胎和绒毛膜癌进行识别和研究。然而，构成着床部位、绒毛膜板、平滑绒毛膜、细胞岛和中隔的滋养层，直到近年来才在文献中受到关注。这些“绒毛外”滋养层细胞最初被称为“X”细胞，因为人们对其来源于母体组织还是胎儿组织存在疑问（70）。随后的研究确定它们起源于滋养层（42），但如今一些研究人员仍在使用X细胞这一术语（30, 4）。由于对其性质和起源仍存在不确定性，人们还使用了许多其他术语，包括合体游走细胞（21）、胎盘部位滋养层、胎盘部位巨细胞（42）、绒毛外滋养层（25）、绒毛外细胞滋养层、非绒毛滋养层和中间滋养层（49）。光学显微镜和免疫组织化学研究已经阐明了绒毛外滋养层的特定形态学和生化特征（48 - 50），该滋养层通常被称为“中间滋养层”。胎盘部位“中间”或绒毛外滋养层的病变包括胎盘部位超常反应、胎盘部位滋养层肿瘤和最近描述的胎盘部位结节。在讨论“中间”滋养层的起源、性质和定义之后，本文将综述这些病变的临床和病理特征、鉴别诊断、治疗及预后因素。
