Abstract
The ability of immunohistochemical staining for human chorionic gonadotropin (hCG) and human placental lactogen (hPL) in tissue obtained by endometrial curetting to distinguish first trimester spontaneous abortions from ectopic pregnancy (EP) was evaluated. Material from 25 patients with uterine bleeding during the first trimester and whose specimens did not contain chorionic villi (CV) on routine histology was stained, and positive results for one or both placental hormones were correlated with subsequent clinical confirmation. Results showed immunohistochemical presence of trophoblasts containing hCG and/or hPL in eight (75%) of the intrauterine pregnancy cases (IUP) with no CV identifiable in routine histological analysis. Human chorionic gonadotropin and hPL were positive in all (100%) cases of IUP with CV (positive control) and negative (0%) in all EP (negative control) cases (P = 0.044). Increased acute inflammation (66% vs 30%, P = .163), vascular wall thickening and occlusion (83% vs 53.8%, P = .25), and decreased Arias-Stella cell changes (50% vs 61%, P = .859) in IUP cases were noted, although none were significant. While the specificities of hCG/hPL positivity and CV are 100% in diagnosing IUP, the sensitivity of CV alone was 45.4% and hCG/hPL positivity was 81.7%. Therefore, in suspected IUP cases, where no CV are seen, hCG and hPL immunostaining may aid in differentiation from EP. Int J Surg Pathol 1(1): 51-56, 1993
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