Ectopic pregnancy

Case contributed by Andrew Van
Diagnosis certain

Presentation

PV bleeding during pregnancy with minimal serum beta HCG level rise.

Patient Data

Age: 30 years
Gender: Female
ultrasound

In the left adnexa, there is a rounded adnexal mass measuring 10 mm with a small echogenic focus displaying some activity on the M-mode (up to 83 bpm). This is suspicious for an ectopic pregnancy.

Case Discussion

Histopathology report attached.

MACROSCOPY:
Left tube with ectopic:  A fallopian tube with fimbrial end 45mm in length with diameter up to 11mm.  The serosa is grey and smooth.  On sectioning, there is a 10mm segment of the fallopian tube which is distended by hemorrhagic material within the lumen up to 8mm in diameter.

A:  Fimbrial end and representative normal appearing TS.
B:  Hemorrhagic segment, all embedded as 3TS.  PE.  (WW/mk/hd)

MICROSCOPY:
Within the lumen of the fallopian tube is a gestation.  The chorionic villi show degenerative change mainly in the form of bloating.  There is no villitis.  No abnormal trophoblast proliferation is seen.  The wall of the tube is intact.  Sections from the distal and proximal tube show a normal mucosal pattern.

CONCLUSION:
Left fallopian tube - ectopic pregnancy.

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