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Chorangioma with trophoblastic proliferation
1Department of Obstetrics and Gynaecology, University of Adelaide, SA, Australia. ykhong@medicine.adelaide.edu.au
Virchows Archiv : an International Journal of Pathology
|February 7, 2001
Summary
Chorangiocarcinomas, placental tumors with vascular and epithelial proliferation, are more common than previously thought. Many chorangiomas exhibit trophoblastic proliferation, suggesting a need for reclassification.
Area of Science:
- Reproductive Medicine
- Gynecologic Pathology
- Perinatal Medicine
Background:
- Chorangiocarcinoma is a rare placental tumor characterized by proliferation of both vascular and epithelial components.
- Only two cases have been previously reported in the literature, suggesting it is an uncommon entity.
Purpose of the Study:
- To investigate the hypothesis that chorangiocarcinomas are more common than reported.
- To re-evaluate histological sections of chorangiomas for features of chorangiocarcinoma.
Main Methods:
- Histological review of 23 chorangioma cases.
- Assessment for syncytiotrophoblast and cytotrophoblast proliferation with nuclear atypia.
- MIB-1 (Ki-67) immunostaining to measure cytotrophoblast proliferation index.
Main Results:
- 65% (15 of 23) of chorangiomas met the diagnostic criteria for chorangiocarcinoma.
- Significantly higher MIB-1 proliferation index in "chorangiocarcinoma" compared to chorangioma (35.4% vs 15.7%, P<0.02).
- No correlation found between trophoblastic proliferation and tumor vascularity, cellularity, infarction, size, location, or patient age.
Conclusions:
- Chorangiomas with trophoblastic proliferation are more frequent than previously suggested by literature reports.
- These lesions, potentially reclassified as chorangiocarcinomas, appear to have a benign clinical course.
- Further investigation into the classification and clinical behavior of these placental tumors is warranted.