胎盘绒毛膜血管瘤25例临床病理分析

Clinicopathologic study of 25 cases of placental chorioangioma

目的探讨胎盘绒毛膜血管瘤的临床病理特点、诊断及鉴别诊断。方法回顾性分析25例胎盘绒毛膜血管瘤的临床病理资料、大体及镜下形态学特点，采用免疫组织化学方法检测肿瘤组织CD34及Ki-67的表达情况。结果25例患者平均年龄29岁，足月产14例，早产10例，胎死宫内1例，19例有妊娠合并症。肿瘤大体表现为凸出于胎盘胎儿面的暗红色、界限较清的结节，直径1～16cm，切面暗红色，部分可为海绵状血管腔，镜下通常表现为小而密集的毛细血管，部分为扩张的海绵状血管，极少数富于细胞，免疫组织化学染色表达CD34，Ki-67阳性指数〈10％。结论胎盘绒毛膜血管瘤较少见，极少数富于细胞性，易被误诊为恶性，常伴发多种妊娠合并症。

Objective To investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma. Methods Twenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohistoehemical staining. Relevant literature was reviewed. Results The average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index 〈 10%. Conclusions Placental ehorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.