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Ectopic Fetal Hepatic Tissue in the Placenta.

David P Stonko1, Jiancong Liang, Amy G Weeks

  • 1Vanderbilt University School of Medicine (D.P.S.) Department of Pathology, Microbiology & Immunology, Pediatric Pathology, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center (J.L., A.E.K.) Department of Obstetrics and Gynecology (A.G.W.) Department of Pathology, Microbiology & Immunology, Gynecologic Pathology (J.C.W.), Vanderbilt University Medical Center, Nashville, TN Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH (R.W.R.) Department of Anatomic Pathology, Boston Children's Hospital, Boston, MA (T.K.B.).

International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists
|June 15, 2018
PubMed
Summary

An unusual placental lesion was identified as ectopic liver, confirmed by specific protein stains (Arginase-1 and HepPar-1). This finding highlights a rare mature hepatocyte phenotype in placental ectopic liver, aiding diagnosis.

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Area of Science:

  • Pathology
  • Reproductive Biology
  • Developmental Biology

Background:

  • Distinguishing intraplacental lesions is crucial for accurate diagnosis, differentiating normal structures, maternal metastases, or primary tumors.
  • Ectopic liver in the placenta is a rare finding, with literature primarily focusing on the fetal hepatocyte phenotype.

Observation:

  • An incidental intraplacental lesion with nondiagnostic morphology and negative Glypican-3 staining was found in a healthy 35-week gestation placenta.
  • Initial negative staining prompted further investigation to identify the lesion's true nature.

Findings:

  • The lesion was confirmed as ectopic liver through positive Arginase-1 and HepPar-1 staining.
  • This case presents a mature hepatocyte immunophenotype, a dichotomy not previously detailed in placental ectopic liver literature.

Implications:

  • The findings suggest a potential mature hepatocyte phenotype in placental ectopic liver.
  • A proposed diagnostic approach using specific markers can identify both fetal and mature hepatocyte phenotypes.
  • This approach may be valuable for assessing other related placental and umbilical pathologies.