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Original Article
- Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease
- Marwa Khashaba, Mohammad Arafa, Eman Elsalkh, Reda Hemida, Wagiha Kandil
- J Pathol Transl Med. 2017;51(4):381-387. Published online June 12, 2017
- DOI: https://doi.org/10.4132/jptm.2017.04.28
- 13,396 View
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- 3 Web of Science
- 4 Crossref
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Abstract
PDF - Background
Although the morphological features characteristic of products of conception specimens including molar pregnancies are well described, substantial histopathological similarities are observed between the different entities, especially in cases of early pregnancies. Furthermore, there are no current solid criteria that could predict cases with progression to persistent gestational trophoblastic disease. In this study, we aimed to determine the most specific histopathological and immunohistochemical features required for accurate diagnosis that can reliably predict the clinical behavior.
Methods
Sixty-five cases of products of conception were reviewed clinically and pathologically, and any progression to persistent gestational trophoblastic disease (GTD), if present, was noted. Pathological assessment of the archival material included re-cut sections of 5 μm in thickness, routine staining with hematoxylin and eosin and immunohistochemical staining of p57Kip2.
Results
Certain histopathological criteria were found to be significant in differentiation between complete hydatidiform mole (CHM) and partial hydatidiform mole including villous shape and outline, villous trophoblast hyperplasia, and atypia in extravillous trophoblasts. There were no significant differences in any morphological or immunohistochemical features between cases with or without subsequent development of GTD.
Conclusions
Histopathological diagnosis of molar pregnancy remains problematic especially in early gestation. Their diagnosis should be stated after a constellation of specific histopathological criteria in order not to miss CHM. p57Kip2 immunohistochemistry is of great value in diagnosis of cases that had equivocal morphology by histopathological examination. However, there were no significant features to predict cases that subsequently developed persistent GTD. -
Citations
Citations to this article as recorded by
- Molecular Basis of Hydatidiform Moles—A Systematic Review
Shadha Nasser Mohammed Bahutair, Rajani Dube, Manjunatha Goud Bellary Kuruba, Rasha Aziz Attia Salama, Mohamed Anas Mohamed Faruk Patni, Subhranshu Sekhar Kar, Rakhee Kar
International Journal of Molecular Sciences.2024; 25(16): 8739. CrossRef - Immunohistochemical expression of BCL-2 in hydatidiform moles: a tissue microarray study
Muna Al-Jabri, Suaad Al-Badi, Hunaina Al-Kindi, Mohammad Arafa
Pathologica.2023; 115(3): 148. CrossRef - Persistent gestational trophoblastic disease following ectopic molar pregnancy
I.N. Voloshchuk, I.V. Barinova, S.N. Buyanova, S.A. Petrakova, N.A. Shchukina, M.V. Mgeliashvili
Arkhiv patologii.2021; 83(1): 44. CrossRef - P57 and Ki-67 expression in hydropic abortion and molar pregnancy
Sylvia A. Ashamallah, Mie A. Mohamed, Hany O. Habashy
Egyptian Journal of Pathology.2017; 37(2): 393. CrossRef
- Molecular Basis of Hydatidiform Moles—A Systematic Review
Case Report
- Complete Hydatidiform Mole with a Coexisting Fetus: A case report .
- Yi Kyeong Chun, Hye Sun Kim, Yee Jeong Kim, Hy Sook Kim, Soo Kyung Choi, So Yeon Park, Sung Ran Hong
- Korean J Pathol. 2000;34(9):673-676.
- 1,635 View
- 16 Download
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Abstract
PDF
- Twin conceptus of a complete hydatidiform mole (CHM) and a normal fetus are rare but are important because of diagnostic difficulty, problems related to twin pregnancy, and high risk of persistent gestational trophoblastic tumor. Recently, we experienced one case of twin pregnancy consisting of a CHM and a normal fetus. A 26-year-old woman complained of vaginal bleeding. She had evidences of pregnancy-induced hypertension. A male fetus was delivered at 20 gestational weeks. The placenta demonstrated vesicles of molar change separated from normal placenta. Microscopically, the molar villi disclosed diffuse hydropic swelling with circumferential trophoblastic proliferation. DNA flow cytometric analysis showed diploid patterns in both molar and normal placental tissues. Fluorescent in situ hybridization in paraffin-embedded tissue presented that normal placental villi hybridized with X- and Y-chromosome probes (46, XY), while molar villi hybridized with X-chromosome only (46, XX). Thus, dizygotic twinning was confirmed because sex differences were shown between molar villi and normal placental villi. Follow up beta-hCG was within normal range after delivery.
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