TY - JOUR
T1 - Rare Complete Hydatidiform Mole With p57 Expression in Villous Mesenchyme
T2 - Case Report and Review of Discordant p57 Expression in Hydatidiform Moles
AU - Murphy, Kathleen M.
AU - Carrick, Kelley
AU - Gwin, Katja
AU - Rogers, Vanessa
AU - Koduru, Prasad
AU - Ronnett, Brigitte M.
AU - Castrillon, Diego H.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Complete hydatidiform mole (CHM) is a premalignant proliferative disease of the placenta characterized by misexpression of imprinted gene products, most notably p57. The majority of CHM exhibit immunohistochemical absence of p57 protein in villous mesenchyme (VM) and cytotrophoblast (CT) and are thus p57 VM/CT concordant. However, some gestations show loss of p57 in only VM or CT, either in all chorionic villi or a subset thereof (VM/CT discordant). Here, we present a rare case of a p57 VM/CT-discordant CHM with diffuse retention of p57 expression in VM but complete absence in CT. Histologically, the case exhibited typical features of CHM including trophoblast hyperplasia and severe nuclear atypia, but was unusual in the presence of gestational membranes identified ultrasonographically and histologically. Ploidy determination by FISH and genotyping by short tandem repeat analyses showed that this was a diploid gestation with variable allelic ratios and with an androgenetic lineage, similar to previously reported p57 VM/CT-discordant cases.
AB - Complete hydatidiform mole (CHM) is a premalignant proliferative disease of the placenta characterized by misexpression of imprinted gene products, most notably p57. The majority of CHM exhibit immunohistochemical absence of p57 protein in villous mesenchyme (VM) and cytotrophoblast (CT) and are thus p57 VM/CT concordant. However, some gestations show loss of p57 in only VM or CT, either in all chorionic villi or a subset thereof (VM/CT discordant). Here, we present a rare case of a p57 VM/CT-discordant CHM with diffuse retention of p57 expression in VM but complete absence in CT. Histologically, the case exhibited typical features of CHM including trophoblast hyperplasia and severe nuclear atypia, but was unusual in the presence of gestational membranes identified ultrasonographically and histologically. Ploidy determination by FISH and genotyping by short tandem repeat analyses showed that this was a diploid gestation with variable allelic ratios and with an androgenetic lineage, similar to previously reported p57 VM/CT-discordant cases.
KW - Chimeric gestation
KW - Gestational trophoblastic disease
KW - Hydatidiform mole
KW - Molecular genotyping
KW - p57
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U2 - 10.1097/PGP.0000000000000773
DO - 10.1097/PGP.0000000000000773
M3 - Article
C2 - 33900230
AN - SCOPUS:85122548962
SN - 0277-1691
VL - 41
SP - 45
EP - 50
JO - International Journal of Gynecological Pathology
JF - International Journal of Gynecological Pathology
IS - 1
ER -