胎盘绒毛膜血管瘤10例临床病理学分析  

Clinicopathological characteristics of placental chorioangioma:a clinicopathologic study of 10 cases

作　　者：古聪敏 何丽娟 施全 高秋 韩瑾 甄理 虞翌旻 李姣玲 

机构地区：[1]广州市妇女儿童医疗中心病理科,广州510180 [2]广州市妇女儿童医疗中心产前诊断中心,广州510180 [3]广州市妇女儿童医疗中心心超声科,广州510180

出　　处：《诊断病理学杂志》2013年第2期70-73,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胎盘绒毛膜血管瘤的临床病理学特点。方法对5年内经病理学检查最终确诊的10例胎盘绒毛膜血管瘤的临床病理学特点进行回顾性分析。结果 10例胎盘绒毛膜血管瘤中,8例在常规产前检查时经彩色多普勒超声检查发现,2例在产后胎盘病检时发现;均为单胎妊娠。6例肿瘤体积较大者中,2例出现妊娠高血压症合并胎儿宫内发育迟缓,2例出现羊水过少,2例出现羊水过多;其中胎盘绒毛膜血管瘤体积最大者孕30周时发展为重度妊高症并胎儿宫内窘迫、胎死宫内。4例肿瘤体积较小者未见伴发妊娠合并症及胎儿宫内发育异常等改变。病理检查示胎盘绒毛膜血管瘤由大量毛细血管样的血管腔隙和中等量疏松结缔组织组成;其中2例肿瘤表面覆盖增生的滋养细胞,为2～3层,伴轻度异型性。结论胎盘绒毛膜血管瘤对围产期结局的影响主要取决于肿瘤大小,肿瘤占位越大并发症越严重,围产儿结局则越不良。胎盘绒毛膜血管瘤伴不同程度滋养细胞增生并不罕见,两者之间的关系有待于长期随访和进一步研究。Objective To review the clinical pathological characteristics in 10 pregnancies complicated by placental chorioangioma. Methods The clinical and pathological characteristics were reviewed and analysed in 10 cases of placental chorioangioma in recent 5 years. Results Among 10 cases of chorioangioma, 8 were diagnosed with Doppler angiography prenatally, and 2 were diagnosed pronatally by pathological biopsy. All eases were diagnosed in single pregnancy. 6 of them with bigger tumor size were associated with pregnant complications, including preeclampsia （ n = 2）, fetal growth restriction （ n = 2 ）, oligohydramnios （ n = 2 ） and polyhydramnios （ n = 2 ）. Severe preeelampsia with fetal intrauterine distress and intrauterine fetal death was found in one patient with the largest size of chorioangioma in 30 gestational weeks. 4 of them with smaller tumor size had no pregnant complications. The pathological diagnosis of chorioangioma was confirmed by the typical abundant vascular proliferation supported by villous stroma of variable cellularity. In 2 cases, syncytiotrophoblast and cytotrophoblast proliferation with mild nuclear atypia and pleomorphism （2- 3 layers ） was seen. Conclusion The size of chorioangioma is associated with an increased risk of pregnant complications. The bigger intraplacental mass is, the poorer perinatal outcome would be. Trophohlastic proliferation is as likely to be seen in chorioangioma. The relationship between angiogenesis in chorioangioma with trophoblastic proliferation and malignant trophoblastic disease would be worthy of further study.

关 键 词：胎盘肿瘤 胎盘绒毛膜血管瘤 妊娠并发症 

分 类 号：R714.7[医药卫生—妇产科学]