Difference between revisions of "Placental site nodule"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Placental site nodule -- very high mag.jpg | |||
| Width = | |||
| Caption = Placental site nodule. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = paucicellular hyaline material scattered cells (variable cell population: small to large cells with clear to eosinophilic cytoplasm), +/-multinucleation, no mitotic activity | |||
| Subtypes = | |||
| LMDDx = invasive [[cervical squamous cell carcinoma]], [[exaggerated placental site]], fibrin +/-inflammatory cells | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Staging = | |||
| Site = [[endometrium]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = previously pregnant | |||
| Signs = | |||
| Symptoms = none | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = none | |||
}} | |||
'''Placental site nodule''', abbreviated '''PSN''', is a benign remnant of a [[placenta]]. It is seen on [[endometrium|endometrial]] biopsies and hysterectomy specimens. | '''Placental site nodule''', abbreviated '''PSN''', is a benign remnant of a [[placenta]]. It is seen on [[endometrium|endometrial]] biopsies and hysterectomy specimens. | ||
'''Implantation site''' redirects here. | |||
==General== | ==General== | ||
*Benign. | *Benign. | ||
| Line 26: | Line 60: | ||
*[[Exaggerated placental site]]. | *[[Exaggerated placental site]]. | ||
**Different histomorphology than PSN; EPS:<ref name=pmid19332926/> syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules. | **Different histomorphology than PSN; EPS:<ref name=pmid19332926/> syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules. | ||
*Fibrin +/-inflammatory cells. | |||
===Images=== | ===Images=== | ||
====Case 1==== | |||
<gallery> | <gallery> | ||
Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC) | Image:Placental_site_nodule_-_intermed_mag.jpg | PSN - intermed. mag. (WC) | ||
Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC) | Image:Placental_site_nodule_-_high_mag.jpg | PSN - high mag. (WC) | ||
</gallery> | </gallery> | ||
www | ====Case 2==== | ||
<gallery> | |||
Image: Placental site nodule -- low mag.jpg | PSN - low mag. | |||
Image: Placental site nodule -- intermed mag.jpg | PSN - intermed. mag. | |||
Image: Placental site nodule -- high mag.jpg | PSN - high mag. | |||
Image: Placental site nodule -- very high mag.jpg | PSN - very high mag. | |||
</gallery> | |||
====www==== | |||
*[http://www.ijpmonline.org/viewimage.asp?img=IndianJPatholMicrobiol_2009_52_2_240_48931_u4.jpg PSN (ijpmonline.org)].<ref name=pmid19332926/> | *[http://www.ijpmonline.org/viewimage.asp?img=IndianJPatholMicrobiol_2009_52_2_240_48931_u4.jpg PSN (ijpmonline.org)].<ref name=pmid19332926/> | ||
*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=12&cat3=1256&stype=d PSN (gfmer.ch)] - includes images from ''Jacob and Mohapatra''.<ref name=pmid19332926/> | *[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=12&cat3=1256&stype=d PSN (gfmer.ch)] - includes images from ''Jacob and Mohapatra''.<ref name=pmid19332926/> | ||
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{{Reflist|1}} | {{Reflist|1}} | ||
[[Category:Gestational trophoblastic disease]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Endometrium]] | |||
Latest revision as of 04:27, 13 May 2016
| Placental site nodule | |
|---|---|
| Diagnosis in short | |
 Placental site nodule. H&E stain. | |
|
| |
| LM | paucicellular hyaline material scattered cells (variable cell population: small to large cells with clear to eosinophilic cytoplasm), +/-multinucleation, no mitotic activity |
| LM DDx | invasive cervical squamous cell carcinoma, exaggerated placental site, fibrin +/-inflammatory cells |
| Site | endometrium |
|
| |
| Clinical history | previously pregnant |
| Symptoms | none |
| Prevalence | common |
| Prognosis | benign |
| Treatment | none |
Placental site nodule, abbreviated PSN, is a benign remnant of a placenta. It is seen on endometrial biopsies and hysterectomy specimens.
Implantation site redirects here.
General
- Benign.
- Intermediate trophoblast remnants from a previous gestation.[1]
- Usually an incidental finding.
Clinical:
- Usually asymptomatic.
- Vaginal bleeding. (?)
- Infertility. (?)
Microscopic
Features:[1]
- Paucicellular with hyaline material scattered cells.
- Variable cell population:
- Small-large cells.
- Clear to eosinophilic cytoplasm.
- +/-Multinucleation.
Notes:
- No mitotic activity.
DDx:
- Invasive (cervical) squamous cell carcinoma.
- Can be sorted-out with IHC (SCC will typically be: p16 +ve, MIB1 +ve).
- Exaggerated placental site.
- Different histomorphology than PSN; EPS:[1] syncytiotrophoblastic tissue, in cords/nests, no hyaline nodules.
- Fibrin +/-inflammatory cells.
Images
Case 1
PSN - intermed. mag. (WC)
PSN - high mag. (WC)
Case 2
PSN - low mag.
PSN - intermed. mag.
PSN - high mag.
PSN - very high mag.
www
- PSN (ijpmonline.org).[1]
- PSN (gfmer.ch) - includes images from Jacob and Mohapatra.[1]
IHC
Features:[1]
- Inhibin alpha +ve.
- CK18 +ve.
- MIB1 low.
Other:
- p16 -ve.
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- CONSISTENT WITH MENSTRUAL ENDOMETRIUM (FRAGMENTED ENDOMETRIUM WITH SIMPLE GLANDS WITH APOPTOTIC CELLS, ABUNDANT NEUTROPHILS, CONDENSED ENDOMETRIAL STROMA (FOCAL) AND BLOOD). - PLACENTAL SITE NODULE AND DECIDUA. - NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.
ENDOMETRIUM, BIOPSY: - PROLIFERATIVE PHASE ENDOMETRIUM. - BENIGN PLACENTAL SITE NODULE, SMALL. - NEGATIVE FOR HYPERPLASIA.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Jacob, S.; Mohapatra, D.. "Placental site nodule: a tumor-like trophoblastic lesion.". Indian J Pathol Microbiol 52 (2): 240-1. PMID 19332926. http://www.ijpmonline.org/text.asp?2009/52/2/240/48931.