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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
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Introduction
Gestational trophoblastic disease
including heterogeneous group of lesions with specific clinical features, morphologic characteristics and pathogenesis
Trophoblasts
- previllous trophoblast
- cytotrophoblast
- Intermediate trophoblast
- villous intermediate trophoblast
- implantation site intermediate trophoblast
- chorionic-type intermediate trophoblast
- syncytiotrophoblast
Immunohistochemical features of the different trophoblastic cell populations in the normal early placenta.
Things to Remember
GTD is a semi-allogenic tissue to the patient:
- abnormally formed placenta (molar pregnancy)
- benign lesions (EPS and PSN)
- neoplasms (choriocarcinoma, PSTT and ETT)
Think about a trophoblastic lesion when a "weird" uterine tumor is encountered
Reproductive ages- symptoms or signs related to an (antecedent) pregnancy;
pregnancy history can be remote in PSTT and ETT
b-hCG is the gold standard surrogate serum marker for follow-up BUT NOT FOR DIAGNOSIS
Immunostaining can be useful
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