胎盘绒毛膜血管瘤8例病理特征及临床意义分析

Pathological Characteristics and the Analysis of Clinical Significance of 8 Cases of Placental Chorioangioma

目的:探讨胎盘绒毛膜血管瘤的病理特征,分析其临床意义。方法:收集我院病理科诊断的8例胎盘绒毛膜血管瘤的临床、病理资料并对其分析。结果:患者年龄23～42岁,平均年龄(28. 5±6. 4)岁,中位年龄26岁。均为剖宫产。子痫前期重度2例,子痫前期轻度1例,羊水过少2例,羊水污染2例,脐绕颈2例。胎儿窘迫3例,有3例NICU入住,低出生体重儿2例。3例经产前超声检查发现,肿瘤直径5～16 cm,超声特点:中等略低回声团块,边界清晰,形态规则,内呈"网格"状改变,血流信号丰富。巨检1例为多发性,2个肿块,直径分别为1. 4和1. 8 cm,其余均为单发性,直径0. 5～16 cm,均边界清楚,切面暗红或暗红、灰白相间,质韧或软。镜检肿瘤内毛细血管样血管密集排列,间质疏松、水肿。可见钙化、坏死(2/8)。可见富于细胞区。肿瘤表面滋养细胞轻度增生(4/8)。结论:胎盘绒毛膜血管瘤是良性肿瘤,表面滋养细胞增生、周围绒毛表面合体滋养细胞结增多及绒毛间隙纤维蛋白沉积是较为常见的伴随现象,较小肿瘤也可合并多种妊娠并发症。应加强产前超声检查,以早期发现肿瘤,及时采取适当措施,降低母儿安全风险。

Objective:To explore the pathological characteristics of placental chorioangioma and analyze its clinical significance.Methods:The clinical and pathological data of 8 cases of placental chorioangioma diagnosed by the pathology department in our hospital were collected and analyzed.Results:Patient age ranged from 23 to 42 years old,average age was(28.5±6.4)years old,median age was 26 years old.They were all cesarean.There were 2 cases of severe preeclampsia,1 case of mild preeclampsia,2 cases of oligohydramnios,2 cases of amniotic fluid contamination and 2 cases of umbilical cord around the neck.There were 3 cases of fetal distress,3 cases of NICU hospitalization and 2 cases of low birth weight infants.Three cases were diagnosed by prenatal ultrasound and the diameter was 5-16 cm.The ultrasonic features were as follows:medium and slightly low echo mass,clear boundary,regular morphological pattern,internal"grid"change,and abundant blood flow signals.Macroexamination,one case was multiple,with 2 lumps,the diameter of 1.4 and 1.8 cm,and the rest were all single,with a diameter of 0.5-16 cm,with clear boundaries,dark red or dark red and white on the cut surface,mass tough or soft.Microscopy revealed dense arrangement of capillary-like vessels,loose and edematous interstitium.With calcification and necrosis(2/8).With a cellular area.Tumor surface trophoblast cells with mild hyperplasia(4/8).Conclusion:Placental chorioangioma is a benign neoplasm.Trophoblastic hyperplasia on the surface of the tumor,hyperplasia of syncytiotrophoblastic node on the surface of surrounding villi and fibrin deposition in the interstitial spaces are relatively common concomitant phenomena.Smaller tumors can also be associated with multiple pregnancy complications.Prenatal ultrasonography should be strengthened to detect the tumor early,so that doctor can take timely and appropriate measures to reduce the risk of maternal and fetal safety.