Histological Differential Diagnosis of Hydatidiform Moles and Hydropic Abortions


Authors: M. Zavadil ;  J. Feyereisl ;  V. Hejda ;  L. Krofta ;  P. Šafář
Authors‘ workplace: Ústav patologie 3. LF UK a FNKV, Praha 1;  Oddělení patologie a molekulární medicíny, FTNsP, Praha 2;  Dermatohistopatologická laboratoř, Praha 3
Published in: Čes.-slov. Patol., 45, 2009, No. 1, p. 3-8
Category: Original Article

Overview

Objective:
To describe the diagnostic methods enabling histological differential diagnosis of complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole, proliferative mole and hydropic abortion.

Methods:
Our study consists of 1321 partial hydatidiform moles, 805 complete hydatidiform moles, 524 proliferative moles, and over 2500 hydropic abortuses diagnosed and treated at the Trophoblastic Disease Center in the Czech Republic (TDC–CZ), Institute for the Care of Mother and Child, plus 2896 of these lesions examined at the TDC–CZ by referral. The material was examined by routine histopathological methods, which in selected cases were supplemented by immunohistological examination and correlated with cytogenetic and molecular genetic results and clinical features.

Results:
The study describes the diagnostic procedures enabling differential diagnosis between mature complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole, proliferative mole and hydropic abortion. Fourteen histological parameters have been defined which are most common, individually or in combination, in various types of hydatidiform moles and hydropic abortions. Warning is given to errors in histological diagnosis, correlated with cytogenetic and molecular genetic results. We propose a reliable method of eliminating the influence of these errors on the possible development of trophoblastic disease.

Conclusion:
The study describes a histological differential diagnosis of complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole,proliferative mole and hydropic abortion.

Key words:
complete hydatidiform mole – immature complete hydatidiform mole – partial hydatidiform mole – proliferative-invasive mole – hydropic abortion – differential diagnosis


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Anatomical pathology Forensic medical examiner Toxicology
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