Immunohistochemical study of inhibin A and B expression in placentas from normal and pathological gestations.

OBJECTIVE: The aim of the study was to examine, by an immunohistochemical method, the distribution of Inhibin-A and -B, in placentas from normal and pathological gestations. MATERIALS AND METHODS: Sixty-two specimens of placental tissue were examined: i) ten cases from early gestations, ii) 28 cases from mature placentas, iii) six cases associated with intrauterine growth restriction, iv) four cases associated with diabetes mellitus and v) 14 placentas from gestations with fetal chromosome abnormalities. The expression of Inhibin A and B was studied by automatic Ventana method. RESULTS: i) Early gestation specimens: Inhibin A (+) immunoreaction was observed in the syncytiotrophoblast (8/10 cases) and in the intermediate trophoblast (6/10 cases). Inhibin B (+) immunoreaction was observed in the syncytiotrophoblast (10/10 cases) and in the intermediate trophoblast (4/10 cases), ii) Normal mature placentas: Inhibin A (+) immunostain was observed in 2/28 cases in the syncytiotrophoblast and in 7/28 cases in the intermediate trophoblast. Inhibin B (+) immunostain was observed in 28/28 cases in the syncytiotrophoblast and in 18/28 cases in the intermediate trophoblast. iii) Placentas associated with intrauterine growth restriction: Inhibin A (+) immunostain was observed in the intermediate trophoblast in 2/6 cases. Inhibin B (+) immunostain was observed in 5/6 cases in the syncytiotrophoblast and in 4/6 cases in the intermediate trophoblast. iv) Placentas associated with gestational diabetes mellitus: Inhibin A (+) immunostain was observed in 2/4 cases in the intermediate trophoblast. Inhibin B (+) immunostain was observed in 2/4 cases in the syncytiotrophoblast. v) Placentas from gestations with fetal chromosome abnormalities: no Inhibin A immunoreaction was observed. Inhibin B (+) immunostain was observed in 13/14 cases in the syncytiotrophoblast and in 9/14 cases in the intermediate trophoblast. The cytotrophoblast, the umbilical cord, and the membranes do not participate in the production of Inhibins. DISCUSSION: Inhibin A and B are located in the syncytiotrophoblast and the intermediate trophoblast of the placenta, during early pregnancy (Inhibin A) and present throughout pregnancy (Inhibin B). No remarkable findings in placentas of pathological gestations support the evidence that Inhibins do not participate in processes that affect the development of the placenta or the fetus, but may participate in,the mechanism of labor.

Epidermoid or dermoid cysts of the ovary? Clinicopathological characteristics of 28 cases and a new pathologic classification of an old entity.

OBJECTIVE: The aim of this study was to present the clinical and pathological findings that aid in the differential diagnosis between epidermoid and dermoid ovarian tumors. MATERIALS AND METHODS: This was a 15-year retrospective clinico-pathological study. A total of 28 cases of epidermoid ovarian cysts histologically confirmed after pathological examination at the Pathology Laboratory of Aretaieion University Hospital between January 1996 and December 2010, were analyzed and a literature review was performed. RESULTS: Patients with epidermoid cysts presented with a main complaint of either abdominal pain or a palpable abdominal mass. In the 28 cases studied, 18 patients underwent cystectomy and four cases underwent oophorectomy. In six cases of post-menopausal women, abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. No recurrent disease in the pelvis was reported during the available follow-up period which was from 12 to 30 months. DISCUSSION: Epithelial epidermoid ovarian tumors represent less than one percent of ovarian surface epithelial tumors. The differential diagnosis of epidermoid cysts includes dermoid (mature cystic teratomas) tumors of the ovary. However, it should be mentioned that up to 17% of teratomas may include epidermoid tumors. In comparison to dermoid cysts which present at an earlier age but with a greater size, ovarian epidermoid tumors present as small- to medium-sized cystic lesions occurring at a significantly older age. The treatment of choice is conservative surgical therapy.