Gestational Trophoblastic Tumors and Related Tumor-Like Lesions

Shih, Ie‐Ming; Mazur, Michael T.; Kurman, Robert J.

doi:10.1007/978-1-4419-0489-8_20

Cited by 21 publications

(23 citation statements)

References 165 publications

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“…In the human placenta, there are different types of trophoblastic cells based on their location, distinct gene expression profiles and specific functions [16]. These include cytotrophoblast which is the germinative component, syncytiotrophoblast which is the terminally differentiated component and responsible for most of the functional activity of trophoblast and intermediate trophoblast (extra-villous trophoblast) which plays an important role in establishing the maternal-fetal blood circulation[16-18]. Among the various trophoblastic subpopulations, syncytiotrophoblast forms a continuous layer of tissue that extends and covers all surfaces of villous trees and part of the inner surface of chorionic and basal plates[17] where it is immersed in the maternal blood in the inter-villous space.…”

Section: Discussionmentioning

confidence: 99%

PD-L1 Expression in Human Placentas and Gestational Trophoblastic Diseases

Veras

Kurman²,

Wang³

et al. 2017

International Journal of Gynecological Pathology

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158

112

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One of the major immune checkpoints responsible for immune evasion in cancer cells is the interaction between programmed cell death-1 (PD-1) and its ligand (PD-L1). Since human trophoblastic cells display many of the features of malignant cells such as the ability to invade normal tissue including blood vessels and are apparently not eradicated by the host immune system, we undertook the present study to determine whether PD-L1 was upregulated in different types of trophoblastic cells during normal pregnancy and in gestational trophoblastic diseases. Immunohistochemistry using an anti-PD-L1 specific antibody demonstrated that in early and term normal placentas, PD-L1 was highly expressed in syncytiotrophoblast and to a much lower extent in intermediate trophoblastic cells located in the chorion laeve and implantation site. PD-L1 immunoreactivity was undetectable in cytotrophoblastic cells. This staining pattern in normal placenta was recapitulated in various types of gestational trophoblastic disease. PD-L1 was highly expressed by syncytiotrophoblast in complete moles and choriocarcinomas. The intermediate trophoblastic neoplasms, placental site trophoblastic tumors and epithelioid trophoblastic tumors, showed variable PD-L1 immunoreactivity but at a lower intensity than in the neoplastic syncytiotrophoblast in choriocarcinoma. In addition, we observed PD-1 positive lymphocytes located within the implantation site and in trophoblastic tumors. In summary, this study describes a novel mechanism for trophoblastic cells to create a tolerogenic feto-maternal interface by upregulating PD-L1 in syncytiotrophoblast and in intermediate trophoblast. Trophoblastic tumors may also use PD-L1 expression to evade the host immune response thereby promoting their survival.

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Section: Discussionmentioning

confidence: 99%

PD-L1 Expression in Human Placentas and Gestational Trophoblastic Diseases

Veras

Kurman²,

Wang³

et al. 2017

International Journal of Gynecological Pathology

Self Cite

158

112

View full text Add to dashboard Cite

show abstract

“…For comparison, reviews and text sources often state that the frequency of HM is approximately 1 to 2 per 1000 pregnancies in North America and Europe 3,4,17,18 and are based on original reports of HM epidemiology that used a variety of methodologies and reference parameters. Comparison of older studies in particular yielded highly inconsistent findings.…”

Section: Discussionmentioning

confidence: 99%

A Reappraisal of the Incidence of Placental Hydatidiform Mole Using Selective Molecular Genotyping

Colgan

Chang

Nanji

et al. 2016

Int J Gynecol Cancer

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“…Studies on gene expression profiles in human trophoblastic subpopulations have elucidated the normal differentiation of trophoblast and relation to intermediate trophoblastic tumors (16). These studies have led to the hypothesis that trophoblastic tumors may recapitulate the development of trophoblast in different locations in the normal early placenta and implantation site (11,12), such that both ETT and PSN are related to the intermediate trophoblast of chorion leave type, whereas PSTT and EPSR are related to the intermediate trophoblast of the normal implantation site. On the basis of morphologic and immunohistochemical studies, PSN may represent the benign counterpart of ETT and EPSR the counterpart of PSTT.…”

Section: Apsn and Association With Malignant Gtdmentioning

confidence: 99%

“…2) (12). APSN are usually larger in size than typical PSN (which rarely exceed 4 mm), have increased cellularity with more cohesive nests and cords of cells, mild cytologic and/or nuclear atypia, and greater Ki-67 labeling index ( Fig.…”

mentioning

confidence: 99%

Atypical Placental Site Nodule (APSN) and Association With Malignant Gestational Trophoblastic Disease; A Clinicopathologic Study of 21 Cases

Kaur

Short

Fisher

et al. 2015

International Journal of Gynecological Pathology

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The WHO Classification of Gestational Trophoblastic Tumors classifies placental site nodule (PSN) as a benign tumor-like trophoblastic neoplasm. Cases of PSN with atypical features were described [atypical placental site nodule (APSN)] and we started registering APSN in our unit in 2005. The aim of this study is to present our initial experience with these lesions. The Trophoblastic Disease Unit database was searched to identify all patients who were either referred with, or on review were diagnosed with, APSN from September 2005 to May 2013. Case notes and the pathology findings for these patients were retrieved and reviewed. A total of 21 cases of APSN were included, 3 of which were associated with gestational trophoblastic neoplasm on follow-up or review. Malignant gestational trophoblastic disease was associated with 3/21 (14%) cases of APSN, either concurrently or developing/manifesting within 16 mo of APSN diagnosis. None of these patients had raised serum hCG levels either at presentation or follow-up. Presence of APSN should indicate a thorough clinical and radiologic investigation and follow-up if diagnosed on curettage specimens. With increased recognition of this entity and corresponding larger series with longer follow-up, more accurate patient counseling will be possible.

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Gestational Trophoblastic Tumors and Related Tumor-Like Lesions

Cited by 21 publications

References 165 publications

PD-L1 Expression in Human Placentas and Gestational Trophoblastic Diseases

PD-L1 Expression in Human Placentas and Gestational Trophoblastic Diseases

A Reappraisal of the Incidence of Placental Hydatidiform Mole Using Selective Molecular Genotyping

Atypical Placental Site Nodule (APSN) and Association With Malignant Gestational Trophoblastic Disease; A Clinicopathologic Study of 21 Cases

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