p57-discordant villi in hydropic products of conception: a clinicopathological study of 70 cases

Genetics of gestational trophoblastic disease

“…A consequence of the wider use of p57 immunostaining has been greater observation of mosaic POC with a molar component, in particular POC comprising two populations of diploid cells, one normal and one androgenetic [42]. These androgenetic/biparental conceptions, comprising up to 2% of POC referred for suspected HM [43], show a wide range of discordant (Figure 2c-d) and divergent p57 expression within and between placental villi [44,45]. While not often having the typical morphology of CHM it is clinically important to recognise these conceptions because of the malignant potential the presence of the androgenetic cell line confers [43,46].…”

Rare Complete Hydatidiform Mole With p57 Expression in Villous Mesenchyme: Case Report and Review of Discordant p57 Expression in Hydatidiform Moles

“…However, caution is warranted given the potential for heterogeneity among villi. Also, because of the relatively small number of p57-discordant cases so far reported, all p57-discordant cases warrant follow-up to exclude persistent gestational trophoblastic disease or disease progression 4 , 12 .…”

“…Deletion of the maternal 11p15.5 chromosomal region encoding CDKN1C /p57 (uniparental disomy) is another plausible mechanism for p57 loss in a distinct placental cell lineage 8 , 9 , 15 . Future studies will benefit from advanced methods such as laser-capture microdissection 12 or single cell sequencing to derive even more detailed molecular profiles of p57-discordant moles and illuminate the origins of their distinct cell lineages. Increased awareness of the phenomenon of p57-discordance and identification of additional cases will aid such investigations.…”

“…However, caution is warranted given the potential for heterogeneity among villi. Also, because of the relatively small number of p57-discordant cases so far reported, all p57-discordant cases warrant follow-up to exclude persistent gestational trophoblastic disease or disease progression (4,12). Lack of p57 expression in CT or VM is indicative of androgenesis of that cell lineage (or less frequently, abnormal imprinting phenocopying androgenesis as in BiHM).…”

Association of Placental Mesenchymal Dysplasia With a Live Female Fetus and Complete Hydatidiform Mole: Report of a Challenging Case Confirmed by Molecular Genotyping Analysis

“…Cases of dichorionic or monochorionic twin pregnancies associating 1 normal placenta and 1 placenta with PMD features have been reported 5,15,16. Although the association of p57-discordant villi (similar to PMD findings) and CHM are sometimes encountered on p57 immunostaining performed on first trimester products of conception 17, second or third trimester twin pregnancies similar to the present case featuring both PMD and CHM have only been described twice 2,8. Paradinas et al 2 reported the presence of a twin pregnancy with a complete mole in 2 of their series of 15 “pseudo-partial” moles, both ending with stillbirths at 17 GW and 27 GW, but details of the pathologic examinations were not reported.…”