Complete hydatidiform mole in twin pregnancy: differentiation from partial mole with interphase cytogenetic and DNA cytometric analyses on paraffin embedded tissues.
Six cases of hydatidiform mole associated with normal chorionic villi and a normal embryo/fetus (in five cases) were investigated with interphase cytogenetic and DNA cytometric analyses for diagnostic purposes. DNA probes specific for the pericentromeric regions of chromosomes 1 and X and for the long arm of chromosome Y were used. In four cases a dizygotic twin pregnancy could be proven. In these cases, the histologically normal chorionic villi showed an XY DNA-diploid pattern, consistent with a normal male conceptus, and the molar chorionic villi a XX pattern. In the other two cases an identical sex chromosomal pattern was found in the normal and in the molar villi (XX/XX and XY/XY respectively). In all six cases the molar placental tissues showed prominent trophoblastic hyperplasia with DNA-polyploidy, consistent with a complete hydatidiform mole. In two cases persistent gestational trophoblastic disease developed. It is emphasized that twin pregnancies composed of a normal conceptus and a complete mole have a relatively high risk for the development of persistent trophoblastic disease and therefore, should be carefully differentiated from triploid partial moles with a relatively low risk of persistent gestational trophoblastic disease. These case reports indicate that additional interphase cytogenetic and DNA cytometric analyses are useful in this differential diagnosis.
Van de Kaa
C A
CA
Institute of Pathology, University Hospital Nijmegen, The Netherlands.
Robben
J C
JC
Hopman
A H
AH
Hanselaar
A G
AG
Vooijs
G P
GP
D000328:Adult; D004273:DNA, Neoplasm / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D006828:Hydatidiform Mole / Q000235:genetics* / Q000473:pathology; D007399:Interphase / Q000235:genetics; D008297:Male; D016612:Paraffin Embedding; D011003:Ploidies; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000235:genetics*; D014427:Twins; D014594:Uterine Neoplasms / Q000235:genetics* / Q000473:pathology
D004273:DNA, Neoplasm