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Pathology of Gestational Trophoblastic Lesions

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Edited by Ie-Ming Shih, MD, PhD
Division of Gynecologic Pathology
Department of Pathology
Johns Hopkins Medical Institutions
E-mail: ishih@jhmi.edu
Tel: (410) 502-7774
1503 E. Jefferson Street, B-315
Baltimore, MD 21231

Lab website: http://pathology2.jhu.edu/shihlab

Special thanks to Dr. Chih-Yi Hsu for his efforts in photomicrographs and legends
Webmaster; Jennifer Parsons Brumbaugh

Diagnostic pathologists in Gynecological Pathology Division
at the Johns Hopkins Hospital:
Robert J. Kurman, MD, Director
Brigitte Ronnett, MD
Ie-Ming Shih, MD, PhD
Russell Vang, MD



Differential Diagnosis- Immunostaining Basis



Information for the antibodies we used

Table 1. Dilutions and Sources of Antibody Panel Used in the Immunohistochemistry
Antigen Antibody* Dilution Source
p63 4A4 1:100 Neomarker
Cytokeratin 18 DC10 1:10 Dako
hPL HPL 1:6,000 Dako
Ki-67 MIB-1 1:1,000 Dako
HLA-G MEM-G/1 1:200 abcam
hCG hCG 1:2,000 Dako
Mel-CAM (CD146) NCL-CD146 1:50 Novo Castra

* All the antibodies are commercially available and work on paraffin sections.

Cytokeratin 18 staining in ETT

Cytokeratin 18 staining in squamous carcinomas

Inhibin-a staining in ETT


Inhibin-a staining in squamous carcinoma


HLA-G immunoreactivity



Chorion laeve

Placental site nodule

ETT
HLA-G immunoreactivity



Trophoblastic column

Choriocarcinoma
HLA-G immunoreactivity


p63 staining in ETT


A mixed case of PSTT and ETT


Double Staining for Mel-CAM and Ki-67


The presence of proliferation activity distinguishes an EPS from a PSTT- a double staining using IT specific marker and Ki-67