Abstract

Exaggerated placental site (EPS) is defined as a non-neoplastic condition in which there is proliferation of number of implantation site intermediate trophoblastic cells that infiltrates the endometrium and myometrium. This is a benign lesion and it’s an exaggeration of normal physiological process as the intermediate trophoblastic cells present in EPS are similar morphologically and immunophenotypically to those found in the normal implantation site. An exaggerated placental site may occur in association with normal pregnancy or an abortion. The significance of reporting this lesion lies in the fact that the cells of this lesion display an identical morphological features to the intermediate trophoblastic cells found in placental site trophoblastic tumour, placental site nodule & epithelioid trophoblastic tumour. To confirm the morphological analysis, we used immunohistochemistry panel comprising of Cytokeratin 18, p63 and ki-67(MIB-1). We here present a rare case of an exaggerated placental site in a 30-year-old female who was in her first trimester of pregnancy and presented with signs of incomplete abortion. DOI: 10.21276/AWCH.1808

Highlights

  • Exaggerated placental site (EPS) is defined as a nonneoplastic condition in which there is proliferation of number of implantation site intermediate trophoblastic cells that infiltrates the endometrium and myometrium. This is a benign lesion and it’s an exaggeration of normal physiological process as the intermediate trophoblastic cells present in EPS are similar morphologically and immunophenotypically to those found in the normal implantation site

  • Emergency curettage was performed as there were signs of incomplete abortion which was sent for histopathology

  • EPS is characterized by an exaggerated and increased infiltration of endometrium and myometrium by intermediate trophoblasts in the implantation area of the placenta. [2,3,4] Intermediate trophoblasts provide foetalmaternal circulation during early pregnancy entering into spiral arteries in the basal layer

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Summary

Introduction

Exaggerated placental site (EPS) is defined as a nonneoplastic condition in which there is proliferation of number of implantation site intermediate trophoblastic cells that infiltrates the endometrium and myometrium. A 30-year-old female, 14 weeks pregnant, presented to gynaecology department with bleeding per vagina, lower abdominal pain along with high fever On examination, her fever was 38°C (100.4°F), her pulse rate was increased and blood pressure was falling. The differential diagnosis was narrowed down to lesions of implantation site intermediate trophoblast (EPS & PSTT) which are CK 18 positive and p63 negative. To differentiate between these two lesions, ki-67 was helpful.

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