Assessment of the role of histopathology and DNA image analysis in the diagnosis of molar and non-molar abortion: A study of 89 cases in the center of Tunisia

Landolsi, Hanène; Missaoui, Nabiha; Yacoubi, Mohamed Tahar; Trabelsi, Amel; Rammeh-Rommani, Soumaya; Hidar, Samir; Gribaa, Moez; Hmissa, Sihem; Mokni, Moncef

doi:10.1016/j.prp.2009.05.013

Cited by 9 publications

(9 citation statements)

References 44 publications

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“…This was statistically significant in differentiation between cases of molar and nonmolar pregnancy but was insignificant in differentiation between the CHM and PHM as described in previous reports [16,17,19]. Trophoblastic hyperplasia is an essential requirement for the diagnosis of molar pregnancy [20].…”

Section: Discussionsupporting

confidence: 51%

Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease

Khashaba

Arafa²,

Elsalkh

et al. 2017

J Pathol Transl Med

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BackgroundAlthough 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.MethodsSixty-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.ResultsCertain 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.ConclusionsHistopathological 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.

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Section: Discussionsupporting

confidence: 51%

Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease

Khashaba

Arafa²,

Elsalkh

et al. 2017

J Pathol Transl Med

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“…Namely, CHM is generally associated with marked villous hydrops with extensive circumferential trophoblast hyperplasia, trophoblastic nuclear pleomorphism, and central villous cistern formation with pushing out of the peripheral villous stroma and no villous blood vessels. 7,35 In PHM, 2 populations of villi commonly exist: enlarged hydropic villi with central cistern formation and small, sclerotic, and normal-sized ones. The degree of hyperplasia may be mild with a patchy distribution.…”

Section: Commentmentioning

confidence: 99%

“…Villous stromal fibrosis is also much more indicative of PHM than CHM. 7,35,36 In addition to histopathology, we used the negativity of p57 KIP2 immunostaining as a specific tool for the diagnosis of CHM. 4,5 In our study, molecular tests for the DNA content in PHM were not available to confirm the triploidy of the mutated cases.…”

Section: Commentmentioning

confidence: 99%

“…4,5 Molecular techniques using the DNA content differences are needed to distinguish between triploid PHM and diploid spontaneous abortion in some challenging cases. 6,7 Most reported cases of HM are sporadic and occur in 1 in 1000 pregnancies in Western countries, but the frequency reaches 1 in 150 pregnancies in Southeast Asia. [8][9][10] Several potential etiologic risk factors have been evaluated for the development of HM.…”

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confidence: 99%

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NLRP7 Mutation Analysis in Sporadic Hydatidiform Moles in Tunisian Patients: NLRP7 and Sporadic Mole

Landolsi¹,

Rittore²,

Hmissa³

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Hydatidiform mole, an aberrant human pregnancy, is commonly a nonrecurrent disease. Recently, a rare autosomal recessive form of familial and/or recurrent molar pregnancies was associated with mutations in the NLRP7 gene. Objective.—To investigate whether NLRP7 mutations exist in Tunisian women with sporadic hydatidiform moles. Design.—Genomic DNA from 38 unrelated Tunisian patients with sporadic hydatidiform moles were screened by sequencing all NLRP7 exons. A high-resolution melting curve analysis was performed on 170 DNA controls to analyze new sequence variants. Results.—More than 13% of these patients were heterozygous for NLRP7 mutations. We found 2 novel missense mutations in the heterozygous state, c.544G>A (p.Val182Met) in 1 patient and c.1480G>A (p.Ala494Thr) in 2 patients, and 2 already reported mutations, c.1532A>G (p.Lys511Arg) and c.2156C>T (p.Ala719Val), in 2 patients. None of these mutations were identified in 170 controls except for 1 woman who was heterozygous for p.Val182Met. Conclusion.—As homozygous NLRP7 mutations are associated with recurrent hydatidiform mole or conception loss, the heterozygous state could represent a risk factor for nonrecurrent mole.

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“…However, especially in early pregnancy, the differences between classical pathological changes in hydropic abortion and various types of molar pregnancies are subtle. Thus, when molecular methods were used, considerable variation in the interpretation of these morphological criteria was observed [1,2,3,8,9].…”

Section: Introductionmentioning

confidence: 99%

Molecular and histological characteristics of early triploid and partial molar pregnancies

Kubelka-Sabit¹,

Jasar²,

Filipovski³

et al. 2017

pjp

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Assessment of the role of histopathology and DNA image analysis in the diagnosis of molar and non-molar abortion: A study of 89 cases in the center of Tunisia

Cited by 9 publications

References 44 publications

Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease

Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease

NLRP7 Mutation Analysis in Sporadic Hydatidiform Moles in Tunisian Patients: NLRP7 and Sporadic Mole

Molecular and histological characteristics of early triploid and partial molar pregnancies

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