Abstract
Giriş:
Plasental Site Nodül (PSN) koryonik tip intermediate trofoblastların
oluşturduğu benign gidişli hücresel proliferasyondur. Genellikle üreme çağında, insidental olarak saptanır. Görüldüğü
en sık lokalizasyon sırasıyla
endometrium ve servikstir. Biz burada servikal yerleşimli ve servikal
lezyona eşlik eden iki PSN vakamızı sunuyoruz.
Olgu:
Vakalarımızdan
ilki 25 yaşındadır. İnfertilite tedavisi
sonrası doğum yapmış ve rutin takip sırasında vajinal smearde LSIL ( low
grade skuamöz intraepitelyal lezyon ) gelmesi üzerine endoservikal kanal küretajı ve servikal punch biyopsi yapılmıştır .İkinci vakamız son
doğumunda postpartum kanama nedeniyle subtotal histerektomi yapılan 50
yaşındaki hastamızdır. Aynı şekilde rutin kontrolde vajinal smearde HSIL ( High
grade skuamöz intraepitelyal lezyon)
gelmesi üzerine endoservikal kanal
küretajı ve servikal punch biyopsi
yapılmıştır. Her iki vakada da küretaj materyalinde servikal dokuların arasında
iyi sınırlı nodüler lezyon görüldü. Her iki nodül de mikroskobik boyutluydu ve
hyalinize matriks içinde nukleusları düzensiz hücreler içermekteydi. Mitoz
görülmedi. Uygulanan immunhistokimyasal çalışmada nodülü oluşturan hücrelerde inhibin
ile immunpozitiflik saptandı, PLAP ve hPL fokal pozitif idi, hCG ile boyanma
görülmedi. İyi sınırlı ve mikroskopik boyutlu olması inhibin ile pozitif
boyanması nedeniyle bu nodüller PSN olarak
rapor edildi. Ayrıca her iki vakada da farklı derecede servikal intraepitelyal
lezyon saptandı.
Sonuç:
Servikal intraepitelyal lezyonlar plasental nodüllere nadir de olsa eşlik
edebilir. Bu birlikteliğin altında yatan nedenlerinin aydınlatılması için
araştırmalara ihtiyaç vardır.
References
- Choi JJ, Emmadi R. Incidental placental site nodule in fallopian tube. İnt J Surg Pathol. 2014;22(1): 90-92.
- Huettner PC, Gersell DJ. Placental site nodule: A clinicopathologic study of 38 cases . Int J Gynecol Pathol. 1994;13:191-198.
- Campello TR,Fittipaldi H, O’Valle F,Carvia RE, Nogales FF. Extrauterine (tubal )placental site nodule. Histopathology. 1998;32:562-565.
- Shih LM,Mazur MT,Kurman RJ .Gestational trophoblastic tumors and related tumor like lesions. In: Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of the female genital track.6 ed. New york : Springer ; 2011; 1121-1125.
- Luna DV,Dulcey I,Nogales FF. Coexistence of placental site nodule and cervical squamous carcinoma in a 72-year-old woman . Int J Gynecol Pathol.2013;32:335-337.
- Al-Hussaini M,Lioe TF,McCluggageWG. Placental site nodule of the ovary Histopathology 2002; 41: 471-472.
- Kouvidou C, Karayianni M,Liapi-Avgeri G. Et al. Old ectopic pregnancy remnants with morphological features of placental site nodule occuring in fallopian tube and broad ligament. Pathol Res Pract 2000; 196: 329-332.
- Young RH, Kurman RJ, Scully RE. Placental site nodules and plaques – A clinicopathologic analysis of 20 cases . Am J Surg Pathol. 1990;14:1001-1009.
- Clement PB, Young RH. Atlas of gynecologic surgical pathology, 2 ed, Boston , Elsevier, 2008; 244-247.
- Dorpe JV. Placental site nodule of the uterine cervix. Histopathology. 1996;29: 379-382.
Abstract
Introduction:
Placental site nodule (PSN) is a cellular
proliferation formed by intermediate trophoblasts and has a benign clinical
course. It usually diagnosed incidentally
during the reproductive period. The most frequent localization of the
PSN is endometrium and uterine cervix, respectively. We herein present two
cases of PSN that located at uterine cervix and accompanied to squamous
intraepithelial lesion (SIL).
Case: The first patient was a
25-year-old female. She recently gave birth after a treatment for infertility.
During her routine follow-up, a low grade-SIL (LSIL) was diagnosed by cytologic
examination of the cervical smear. Then, an endocervical curretage and a cervical
punch biopsy were performed. The second patient was a 50-year-old female.
During her routine cervical smear analysis, a high grade SIL (HSIL) was
diagnosed, and then an endocervical curretage and a cervical punch biopsy were
done. Histopathologically, both cases displayed well-demarcated nodules among
the cervical tissue. Both nodules were microscopic in size and exhibited cells
with irregular nuclei within a hyalinized matrix. No mitotic figure was
detected. Immunohistochemically, abovementioned cells were diffusely positive
for inhibin and focally positive for
PLAP and hPL. For these nodules were well-demarcated, small in size, immunohistochemically
positive for inhibin we diagnosed and reported them as PSN. Furthermore, both
cases also showed SIL-type lesions with different degrees.
Conclusion:
Cervical
lesions can accompany placental nodules. The underlying cause of this coexistence
needs to be revealed through further studies.
References
- Choi JJ, Emmadi R. Incidental placental site nodule in fallopian tube. İnt J Surg Pathol. 2014;22(1): 90-92.
- Huettner PC, Gersell DJ. Placental site nodule: A clinicopathologic study of 38 cases . Int J Gynecol Pathol. 1994;13:191-198.
- Campello TR,Fittipaldi H, O’Valle F,Carvia RE, Nogales FF. Extrauterine (tubal )placental site nodule. Histopathology. 1998;32:562-565.
- Shih LM,Mazur MT,Kurman RJ .Gestational trophoblastic tumors and related tumor like lesions. In: Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of the female genital track.6 ed. New york : Springer ; 2011; 1121-1125.
- Luna DV,Dulcey I,Nogales FF. Coexistence of placental site nodule and cervical squamous carcinoma in a 72-year-old woman . Int J Gynecol Pathol.2013;32:335-337.
- Al-Hussaini M,Lioe TF,McCluggageWG. Placental site nodule of the ovary Histopathology 2002; 41: 471-472.
- Kouvidou C, Karayianni M,Liapi-Avgeri G. Et al. Old ectopic pregnancy remnants with morphological features of placental site nodule occuring in fallopian tube and broad ligament. Pathol Res Pract 2000; 196: 329-332.
- Young RH, Kurman RJ, Scully RE. Placental site nodules and plaques – A clinicopathologic analysis of 20 cases . Am J Surg Pathol. 1990;14:1001-1009.
- Clement PB, Young RH. Atlas of gynecologic surgical pathology, 2 ed, Boston , Elsevier, 2008; 244-247.
- Dorpe JV. Placental site nodule of the uterine cervix. Histopathology. 1996;29: 379-382.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 29, 2017 |
| Published in Issue | Year 2017 Volume: 48 Issue: 3 |
