Distinctive flow histogram pattern in molar pregnancies with elevated maternal serum human chorionic gonadotropin levels

Bocklage, Thèrése; Smith, Harriet O.; Bartow, Sue A.

doi:10.1002/1097-0142(19940601)73:11<2782::aid-cncr2820731122>3.0.co;2-a

Cited by 9 publications

(1 citation statement)

References 25 publications

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“…This past year has been a good year for trophoblastic disease studies, with a flurry of reports published both in Histopathology and in US-based publications. In addition to those described above, interesting studies have emerged in the area of genomic imprinting 19 and in DNA flow cytometry studies evaluating other parameters of DNA histograms besides DNA ploidy in hydropic abortions and hydatidiform moles 20 .…”

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Hydatidiform moles: DNA flow cytometry, image analysis and selected topics in molecular biology

Lage

Bagg

1996

Histopathology

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Histopathology recently published an article by Paradinas and colleagues on their investigation of the clinical, pathological and DNA flow cytometric characteristics of hydropic abortuses and hydatidiform moles 1 . Two other articles on hydatidiform mole have also been published in Histopathology, one by Jeffers et al. 2 reporting on the concordance rate of DNA content measurements obtained by image analysis and flow cytometry and the second by Cheung et al. 3 on the expression of three markers: cathepsin D (a proteinase thought to be involved in tumour invasion and metastatsis) and oestrogen and progesterone receptors.A short review is in order. Gestational trophoblastic tumours may be divided dichotomously into those with villi and those lacking villi. In the former category are the hydatidiform moles; partial hydatidiform mole and complete hydatidiform mole. The avillous category comprises the more malignant trophoblastic tumours, placental site trophoblastic tumour and choriocarcinoma. The benign nature of the placental site nodule, save for a few case reports to the contrary, is well-accepted, and will not be discussed further.Correct diagnosis of a fully developed complete hydatidiform mole is easily achieved in most instances with only the early, 'immature' (i.e. less than 8-10 weeks gestational age) lesions being problematic. Though the diagnosis of partial mole at any gestational age is unchartered territory for some pathologists, it too is fairly easily recognized in its most florid state. An 'early' partial mole may be subject to misinterpretation as an hydropic abortion, its true nature becoming evident upon repeat curettage or outside review.Since the majority of partial hydatidiform moles are triploid and the majority of complete moles are diploid/ tetraploid, results of DNA ploidy studies obtained either from DNA flow cytometry, image (static) cytometry, or cytogenetic studies are useful for distinguishing between these hydatidiform lesions. Unfortunately, (or fortunately, if you're interested in remaining employed), results of DNA ploidy studies alone cannot accurately classify these lesions since their morphological cousins, the hydropic abortions, share many features overlapping those of the hydatidiform moles, and may be DNA diploid, triploid, tetraploid (polyploid) or aneuploid. Furthermore, not all triploid placentas are partial hydatidiform moles. Approximately 15% of triploid, hydropic placentas are maternally derived, owing their triploid state to an extra maternal (rather than paternal) haploid DNA dose, and, both morphologically and biologically, are not partial moles. Thus, though quite helpful, knowledge of DNA ploidy alone is insufficient for establishing a diagnosis.In the past few years, many studies have examined the relationship between DNA ploidy and morphology in hydatidiform moles 5ÿ10 . The earliest ones were retrospective, evaluating only a handful of cases. Though a dichotomous distinction became evident, the water was muddied by misinformation added to the literature, predo...

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