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目的探讨双胎之一完全性葡萄胎与胎儿共存的病理特征及临床意义。方法分析3例双胎之一完全性葡萄胎与胎儿共存的临床资料、大体形态、组织学表现、免疫组化染色及荧光原位杂交结果,结合相关文献,探讨其临床病理特征和鉴别诊断。结果 3例孕周分别为11周、14周和35周。3例大体检查均显示为两个分离的组织,一个为正常胎盘,一个为葡萄胎。正常胎盘绒毛发育良好,葡萄胎绒毛水肿。免疫组化示两部分的绒毛对p57,p53,Ki-67呈不同的表达。荧光原位杂交显示葡萄胎绒毛的细胞滋养细胞为二倍体。结论双胎之一完全性葡萄胎与胎儿共存病例较为罕见,正确诊断对预后有重要临床意义。免疫组化p57和荧光原位杂交对诊断有帮助。
Objective To investigate the pathological features and clinical significance of the coexistence of complete hydatidiform mole and fetus. Methods The clinical data, gross morphology, histological features, immunohistochemical staining and fluorescence in situ hybridization of complete hydatidiform mole and fetus in one of the three twins were analyzed. The clinical and pathological features and differential diagnosis were analyzed with related literatures. Results Three gestational weeks were 11 weeks, 14 weeks and 35 weeks respectively. Three cases of gross examination showed two separate tissues, one for the normal placenta and one for the hydatidiform mole. Normal placental villi well developed, hydatid hair dropsy. Immunohistochemistry showed that the two parts of the villus p57, p53, Ki-67 showed different expression. Fluorescent in situ hybridization showed that the villi of trophoblastic cells were diploid. Conclusions One of the twins has a rare case of complete hydatidiform mole and fetus coexistence. Correct diagnosis has important clinical significance for prognosis. Immunohistochemistry p57 and fluorescence in situ hybridization diagnosis.