mesenchymale Dysplasie der Plazenta

Placental
mesenchymal dysplasia: What every radiologist needs to know In an 18-year-old female at 15-week gestation, transabdominal ultrasonography (TAS) of pelvis (A-C) shows mildly enlarged, low lying, posteriorly placed placenta. Lower part of the placenta shows multiple anechoic cysts (arrows) which are extending inferiorly and covering the internal os. On color Doppler imaging (D), low velocity signals were seen in the multicystic placental lesion
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MRT (T2)
einer Mesenchymalen Dysplasie der Placenta mit drohender Plazentainsuffizienz in der 34. Woche. Die Placenta ist großvolumig mit multiplen zystoiden Auflockerungen. Sie befindet sich in der Fruchtblase mit dem Kind; dies im Gegensatz zur Differenzialdiagnose einer Molenschwangerschaft mit gleichzeitig bestehendem Fetus daneben.
Wikipedia • CC BY-SA 4.0
Placental
mesenchymal dysplasia, a case of intrauterine sudden death of fetus with rupture of cirsoid periumbilical chorionic vessels. Transvaginal ultrasound study. An apparently normal fetus (asterisk) and villi with multiple hypoechoic cysts (arrows) at 8 weeks" gestation. Crown-rump length is 20 millimeters. Each cyst is 2-3 millimeters in diameter.
diagnosticpathology.biomedcentral.com • CC-by-2.0
Placental
mesenchymal dysplasia, a case of intrauterine sudden death of fetus with rupture of cirsoid periumbilical chorionic vessels. Transabdominal ultrasound study. Placental parenchyma (asterisk) and dilated subchorionic vessels (arrows) at 35 weeks" gestation. These vessels are up to 2.5 centimeters in diameter.
diagnosticpathology.biomedcentral.com • CC-by-2.0
Infantile
hepatic hemangioma and hepatic mesenchymal hamartoma in an infant associated with placental mesenchymal dysplasia: a case report. A Maternal surface of placenta shows multiple cysts of various size (arrowheads). B Microscopically, the placenta shows enlarged stem villi with hydropic changes (hematoxylin and eosin). C Hemangioma-like collections of abnormal blood vessels are slightly visible (hematoxylin and eosin)
surgicalcasereports.springeropen.com • CC-by-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Placental mesenchymal dysplasia (PMD) is a rare, benign condition that is characterized by enlargement of the placenta with multiple bunches of grape-like vesicles that can resemble a molar pregnancy by ultrasound and gross pathologic examination.

Epidemiology

This is an often underdiagnosed and underreported case due to lack of awareness. It has been documented to be more in female fetuses with an F:M of ~3.5:1.

Clinical presentation

Clinical presentation is diverse and non-specific

  • uneventful pregnancy with postnatal pathologic findings of PMD
  • incidental ultrasonographic abnormalities of the placenta
  • elevated maternal serum alpha-fetoprotein concentrations
  • fetal growth restriction
  • fetal demise
  • vaginal bleeding
  • preterm delivery

Associations

Radiographic features

Ultrasound

The placenta is thickened with multiple cystic or hypoechoic areas. Doppler findings are variable. There are many documented cases of no vascularity within the lesion and further development of vascularity within. These changes could be due to progressive dilatation of chorionic arteries and veins that become aneurysmal.

MRI

One study showed that MRI could help differentiate between complete hydatidiform mole with coexistent fetus (CHMCF) by demonstrating PMD as multicystic lesions within the placenta of the fetal sac, and CHMCF with multicystic lesions located within an extra fetal sac .

Treatment and prognosis

The outcome of the fetus is variable ranging from a completely normal fetus to an increased risk of IUGR or fetal demise.

History and etymology

It was first described in 1991 by Moscoso et al.

Differential diagnosis

Possible differential considerations include

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu mesenchymale Dysplasie der Plazenta:
Blasenmole
 
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