Document Detail


Over-diagnosis of hydatidiform mole in early tubal ectopic pregnancy.
MedLine Citation:
PMID:  11422477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Tubal ectopic hydatidiform moles are rare lesions, and only 40 cases have been reported in the world literature. We investigated the apparently high incidence of tubal ectopic hydatidiform moles in women referred for treatment to a Supraregional Trophoblastic Tumour Screening and Treatment Centre between 1986 and 1996. METHODS AND RESULTS: Of 4261 women referred during the study period, 25 (0.6%) had a suspected tubal ectopic hydatidiform mole and paraffin-embedded tissue was available in 20 (80%) of these. Each case was reviewed by two pathologists and DNA flow cytometric analysis was undertaken when the histological diagnosis was initially deemed equivocal or suggestive of hydatidiform mole. On review, 17 cases (85%) showed no evidence of hydatidiform mole (circumferential trophoblastic proliferation, hydrops, scalloped villi, and stromal karyorrhexis). Of these, 11 cases (65%) showed features of early placentation and six (35%) showed hydropic abortion. DNA flow cytometry was performed in 14 (82%) of these cases and revealed a diploid population in each case. Three cases of molar pregnancy (15%) were identified. Each of these cases had the histological features of an early complete hydatidiform mole. Sufficient tissue was available for DNA flow cytometric analysis in two of these cases and confirmed the presence of diploidy in each. CONCLUSION: Our results show that tubal ectopic hydatidiform mole is a rare entity and demonstrate that it is over-diagnosed. Polar trophoblastic proliferation and hydropic villi are features of early placentation and of hydropic abortion. Sheets of extravillous trophoblast may be particularly prominent in tubal ectopic gestation. In the absence of circumferential trophoblastic proliferation combined with hydropic change a diagnosis of gestational trophoblastic disease should be avoided.
Authors:
J L Burton; E A Lidbury; A M Gillespie; J A Tidy; O Smith; J Lawry; B W Hancock; M Wells
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Histopathology     Volume:  38     ISSN:  0309-0167     ISO Abbreviation:  Histopathology     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-06-25     Completed Date:  2001-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704136     Medline TA:  Histopathology     Country:  England    
Other Details:
Languages:  eng     Pagination:  409-17     Citation Subset:  IM    
Affiliation:
Section of Oncology and Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK. j.l.burton@shef.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous
Adult
DNA, Neoplasm / genetics
Diagnosis, Differential
Female
Flow Cytometry
Humans
Hydatidiform Mole / pathology*
Maternal Age
Pregnancy
Pregnancy, Ectopic / pathology*
Registries / statistics & numerical data
Uterine Neoplasms / pathology*
Chemical
Reg. No./Substance:
0/DNA, Neoplasm
Comments/Corrections
Comment In:
Histopathology. 2001 Sep;39(3):320-1   [PMID:  11532043 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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