I
N SUMMARY HST 071
T
ROPHOBLASTIC DISEASE
T
ROPHOBLASTIC NEOPLASIA
T
ypes of trophoblast neoplas ia
• M
olar (always gestational)
o v
illi
• N
on
-m
olar (can be non
-g
estational)
o N
o villi
• M
olar gestations
o E
rrors in fertilization o
r
meiosis
o A
bnormal paternal contribution to the zygote
• T
wo categories:
o C
omplete hydatidiform mole
o P
artial hydatidiform mole
P
artial Hydatidiform Mole
• E
xcess tissue:
o O
ccasionally large villi are grossly identifiable but should be < 1cm in
g
reatest dimensi
o
n
• F
etal development is possible with characteristic anomalies:
o I
UGR
o 3-4
syndactyly
-
hands
o 2-3
syndactyly
-
feet
o R
enal, cardiac, neural structural anomalies
• H
istology:
o T
wo populations villi
-
l
a
rge + cisterns, small
o I
rregular outlines of villi
o V
illous syn
c
ytiotrophoblastic inclusions
o E
xcess and atypical villous synctyiotrophoblast
o “
molar” implantation site
o E
mbryonic/fetal development
•Ch
aracterized by focal villous hydrops
•Fo
cal trophoblastic hyperppasia
•Tw
o populations of villi
–l
arge and hydropic
–b
ackgro
u
nd of small, sclerotic and normal
-s
ized villi
–s
calloped villous outlines
–t
angential sectioning of the villi results in stromal trophoblastic
i
nclusions
–v
illous surfaces may have many tiny projections of syncytiotrophoblast
f
orming notches
•F
ocal trophoblas
t
hyperplasia
•M
ounds of syncytiotrophoblast
•N
uclear atypia infrequent
•V
illi vessels contain nucleated R BS and often fetal tissue found
•T
riploid
•E
xtra haploid DN A is paternal
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