Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform mole

Bagshawe, K. D.; Lawler, Sylvia D.; Paradinas, F. J.; Brown, Patrick; Boxer, G. M.

doi:10.1016/0140-6736(90)92641-t

Cited by 140 publications

(49 citation statements)

References 19 publications

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“…A study performed by [28] they reported that eight of their 81 patients (9.9%) had the disease. Additionally, other studies reported complete mole may be ranged in cases 10% -20%, and partial mole from 0.5% -6.6% [29]- [31].…”

Section: Discussionmentioning

confidence: 99%

Anatomical and Histopathologic Analysis of Placenta in Dilation and Evacuation Specimens

Hassan¹,

Hegazy²,

Mosaed³

2014

FMAR

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Background: Anatomical and histopathologic examination of placenta in cases of abortion is crucial as to clarify the underlying causes of many adverse pregnancy outcomes. Dilation and evacuation (D&E) is the most common mode of uterine evacuation that commonly examined in pathology sections. The aim of this study is to discuss the various placental pathologies, and to demonstrate the importance of careful pathologic examination of D&E material, also to review the anatomy of placenta and to compare our findings with other publications worldwide. Material and Methods: A retrospective descriptive study for 200 placental tissues was collected in 18 months period and revised for normal anatomy and various placental pathologies. These placentas were obtained by dilation and evacuation (D&E) technique. All cases were undergone for histopathological sections that were stained by Hematoxylin and Eosin (H&E). Results: Placental infarction was observed in 25% of cases, and chorioammnitis was the most common form of placental infection and found in 12.5%. Molar changes were represented a lowered percentage of placental pathologies that found in 9% of specimens. Conclusion: Study and recognition of placental lesions among general surgical pathologists have clinical significance and awareness of deficiency, standardization of diagnostic criteria, and increased knowledge in placental pathology improve the quality of diagnosis in this area.

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Section: Discussionmentioning

confidence: 99%

Anatomical and Histopathologic Analysis of Placenta in Dilation and Evacuation Specimens

Hassan¹,

Hegazy²,

Mosaed³

2014

FMAR

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“…Bagshawe et al found that in five of 11 partial mole cases (45%) the diagnosis of partial mole could be confirmed after histological examination and DNA ploidy analysis. 2 In the remaining six cases, the diagnosis was revised to complete mole in four and non-molar pregnancy in two cases. In another study, 55% of partial mole cases were DNA triploid.…”

Section: Discussionmentioning

confidence: 99%

“…The distinction between complete moles, partial moles, and non-molar hydropic abortuses is important because complete moles are more likely to progress to persistent trophoblastic disease than partial moles, with risk of metastases and choriocarcinoma. 2 Complete mole is characterised by gross hydropic swelling of most of the chorionic villi with loss of intravillous vascularity and absence of a fetus. It occurs as a result of fertilisation of an empty egg devoid of maternal chromosomes by a single spermatozoon (in most cases) that duplicates its 23,X chromosomal content to produce 46,XX, or by two spermatozoa (about 25% of cases) to produce a dispermic 46,XX or 46,XY conceptus.…”

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confidence: 99%

Interphase cytogenetic and AgNOR analyses of hydatidiform moles.

et al. 1998

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Aim-To determine the potential value of interphase cytogenetic and argyrophilic nucleolar organiser region (AgNOR) analyses in the diagnosis and classification of hydatidiform moles. Methods-Serial tissue sections from 37 hydatidiform moles, histologically classified as 11 complete and 15 partial, and from 11 hydropic abortuses were examined by in situ hybridisation using digoxigenin labelled probes specific for chromosomes 1, X, and Y, and a one step silver staining method. The percentages of diploid and triploid nuclei, and the mean number of AgNORs for each tissue were determined. Results-Interphase cytogenetics showed that eight of the 11 cases (73%) each of complete mole and hydropic abortus had diploid pattern and the three remaining cases (27%) of each group were triploid. Two of the triploid complete moles and one of the triploid hydropic abortuses were revised to partial moles and one remaining triploid complete mole was revised to hydropic abortus. Of the 15 partial moles, nine (60%) were triploid, and six (40%) were diploid. These diploid cases were revised to three complete moles and three hydropic abortuses. There was a significant diVerence (p < 0.0001) between the mean (SD) AgNOR count in partial mole (5.11 (0.91)) versus hydropic abortus (3.79 (0.90)) and complete mole (3.39 (0.97)). The total of 15 triploid cases showed a high mean AgNOR count of 5.24 (0.73). Also, after reclassification, eight of the nine partial moles (89%) had a mean AgNOR count of > 5. The results of analyses by the two methods were closely correlated. Conclusions-Interphasecytogeneticanalysis using chromosome specific probes and AgNOR count provides a valuable approach for ploidy analysis in histological sections of hydatidiform moles and helps to resolve diYcult cases. (J Clin Pathol 1998;51:438-443)

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“…3,4 The reported incidences of subsequent development into gestational trophoblastic neoplasia requiring chemotherapy following complete and partial moles were quite variable, affected by the referral patterns, diagnostic criteria, and criteria for post-evacuation chemotherapy. 1,2,5,6 However, it is generally believed that such a risk is much higher after a complete mole when compared with a partial mole. The incidences of post-evacuation gestational trophoblastic neoplasia ranged from 8 to 29% in a complete mole and 0.5-5.5% in a partial mole.…”

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confidence: 99%

Analysis of gestational trophoblastic disease by genotyping and chromosome in situ hybridization

et al. 2003

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Hydatidiform mole is classified into partial and complete subtypes according to histopathological and genetic criteria. Distinction between the two by histology alone may be difficult. Genetically, a complete mole is diploid without maternal contribution, whereas a partial mole is triploid with a maternal chromosome complement. To assess the accuracy of histological diagnosis by correlating with the genetic composition, we performed fluorescent microsatellite genotyping to detect the presence or absence of maternal genome in a hydatidiform mole and carried out chromosome in situ hybridization to analyze the ploidy. For genotyping analysis, paraffin sections of 36 complete and nine partial moles, diagnosed according to histological criteria, were microdissected and DNA was separately extracted from the decidua and molar villi. Six pairs of primers that flank polymorphic microsatellite repeat sequences on five different chromosomes were used. In all, 34 cases, including 31 complete moles and three partial moles diagnosed histologically, showed no maternal contribution by genotyping; thus these could be genetically considered as complete mole. The other 11 cases (five complete moles and six partial moles previously diagnosed by histology) showed the presence of maternal contribution and were genetically diagnosed as partial moles. The genotyping results correlated with histological evaluation in 88% (37/45) of hydatidiform mole and correlated with chromosome in situ hybridization findings in all the cases, that is, triploid hydatidiform moles had maternal-derived alleles, while diploid hydatidiform moles were purely androgenetic. Compared with genetic diagnosis, histological evaluation was more reliable for the diagnosis of a complete mole (91%, 31/34) than that of a partial mole (55%, 6/11) (P ¼ 0.0033). Seven complete moles and three partial moles diagnosed genetically developed gestational trophoblastic neoplasia. To conclude, genotyping and chromosome in situ hybridization can provide reliable adjunct to histology for the classification of a hydatidiform mole, especially in cases with difficult histological evaluation and early gestational age. As a partial mole still carries a risk of developing gestational trophoblastic neoplasia, follow-up is considered necessary for both complete and partial moles.

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Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform mole

Cited by 140 publications

References 19 publications

Anatomical and Histopathologic Analysis of Placenta in Dilation and Evacuation Specimens

Anatomical and Histopathologic Analysis of Placenta in Dilation and Evacuation Specimens

Interphase cytogenetic and AgNOR analyses of hydatidiform moles.

Analysis of gestational trophoblastic disease by genotyping and chromosome in situ hybridization

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