3例胎盘部位滋养细胞瘤的临床病理分析

Pathological analysis of placental site trophoblastie tumor

目的分析胎盘部位滋养细胞肿瘤（placental site trophoblastic tumor，PSTT）的病理形态特征及与其他肿瘤的鉴别诊断要点。方法对3例PSTT进行组织形态学、免疫组织化学和血清β-hCG水平分析，结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果PSTT的主要临床症状为月经不调、阴道不规则出血等。肿瘤由形态多样的上皮样细胞构成，胞质嗜酸性或透亮，来源于中间型滋养细胞。免疫组织化学瘤细胞表达CK、MBP、HCG、HPL等。结论PSTT是一种极少见的肿瘤，临床表现缺乏特异性，早期诊断十分困难。根据其组织学改变，免疫组化染色结果及血清β—hCG水平，可与其他肿瘤鉴别。

Objective To investigate the clinical pathological characteristics and the differential diagnosis of placental site trophoblastic tumor （PSTT）. Methods Three cases of PSTT were collected for study, and the clinical pathological features and differential diagnosis of PSTT were investigated by histomorphology, immunohistochemistry and serum B-hCG measurement. Results The most frequent symptoms of PSTT were menoxenia and abnormal vaginal bleeding. The tumor cells were composed of polymorphic epithelioid cells with eosinophilicor clear cytoplasm and derived from intermediate trophoblast （IT）, and could expressed CK, MBP, HCG and HPL. Conclusions PSTT was a rare kind of tumor and the characteristic clinical manifestations was unconspicuous. It could be differentiated from other tumors based on the histopathologic features and immunohistochemical findings and serum B-hCG determination.