胎盘间叶发育不良？讨论病例【中美加胎盘病理交流群病例2】

小王

郭晓静
女，25岁，35周早产





















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白草糖
胎盘间叶发育不良吗

郑良楷
我也同意

郭晓静
@白草糖 这个病例是其他医院给我的 您其实帮我把过关的 可不可以帮着解释下 谢谢王老师！

白草糖
我自己也只经手过一例，干绒毛粗大，间质里有厚壁的肌性血管，部分绒毛水肿，间质有黏液变，或者中央池形成，但是没有滋养叶细胞增生，肉眼常见细小水泡，大体看胎盘是塌陷的，超声容易误认为是葡萄胎，有些孩子会合并巨舌或者脐疝，就记得这些了

郭晓静
@白草糖 学习了！第一次见 。胎盘大体部分区域是水泡状的。谢谢！

邢德印
@深圳市人民医院病理科郭晓静 @王昀 301病理 英文placental mesenchymal dysplasia吗？厉害. p57做了吗？

郭晓静
@邢德印 邢老师好！没有做p57。是外院同行给我的病例 我是第一次见   王老师帮忙诊断的。还有白片  可以试做一下。弱弱的问一句  这项免疫组化有什么意义么？谢谢！

白草糖
好像应该是细胞滋养细胞阳性，间质阴性

邢德印
@深圳市人民医院病理科郭晓静 一般细胞滋养细胞阳性，间质stroma 阴性；

郭晓静
@王昀 301病理 是的 王老师。后来  他们给我切了一些白片。Mesenchymal Dysplasia of Placenta – Retrospective Study of 8707 Human Placentas
Sarka Hadravska1, Magdalena Dubova2, Ondrej Daum2, Bohuslava Saskova3, Martina Putzova2, Petr Mukensnabl2, Michal Michal1
1Biopticka Laborator SRO, Plzen, Czech Republic, 2Biopticka laborator s.r.o., Plzen, Czech Republic, 3Biopticka Laborator Plzen,
Plzen, Czech Republic
Disclosures: Sarka Hadravska: None; Magdalena Dubova: None; Ondrej Daum: None; Bohuslava Saskova: None; Martina Putzova:
None; Petr Mukensnabl: None; Michal Michal: None
Background: Mesenchymal dysplasia of placenta (MDP) is a rare (published frequency range: 0.002-0.2%) and still mysterious placental
anomaly with ,,grape-like vesicles” resembling partial hydatidiform mole by USG and macroscopic examination, apparently often
associated with Beckwith–Wiedemann syndrome (BWS) and female sex of the fetus. The etiology is not yet fully understood.
Design: During the period January 1995 – July 2018 we examined 8707 placentas, 7 of them having been found to represent cases of
MDP. Cytogenetic and DNA ploidy studies, and immunohistochemical staining for p57KIP2 was performed in all 7 cases with histologic signs
of MDP (i.e. edematous stem villi with cisterns and thick-walled vessels, normal terminal villi, and lack of trophoblastic proliferation,
inclusions and scalloping of villi).
Results: All mothers were healthy, details on pregnancies and fetal and placental findings are shown in Table 1. Briefly, in 4 cases (A-D)
the prenatal USG or genetic findings led to termination of pregnancy, case E was a missed abortion, in cases F (male mo-bi twins) and G
fetuses were delivered spontaneously and are healthy. Immunohistochemical staining for p57KIP2 was positive in villous stromal and
cytotrophoblastic cells in all villi including cystic stem villi in all cases.