title: P57kip2 immunohistochemical expression and ultrastructural findings of gestational trophoblastic disease and related disorders.
abstract: Gestational trophoblastic disease (GTD) is a unique spectrum of diseases ranging from complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and invasive mole (IM) to choriocarcinoma (CC). Placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT) have been classified as related disorders. Mesenchymal dysplasia (MD) may be misdiagnosed as PHM; however, it is said to have a quite different histogenesis from PHM. P57kip2 is the protein product of a paternally imprinted or maternal gene that inhibits cyclin-dependent kinases (CDK), thus serving to inhibit cell proliferation and to suppress tumor growth. Its lack of expression in trophoblastic disease plays a role in its abnormal proliferation and differentiation. In this study, P57kip2 immunostaining was absent in the trophoblastic layers of CHM and was positive in the trophoblast layer of nonmolar villi and MD. Ultrastructure of complete molar cystic villi showed tree-like branching of microvillous processes and intracytoplasmic lacunae without capillaries in the stroma, whereas MD contained many newly formed blood vessels and collagen. Also, large lacunae with microvilli and polymorphic nuclei of syncytiotrophoblast cells with well-developed organelles were observed in IM. Lung ETT following CHM and normal deliveries showed two types of large mononuclear cells and binuclear cells with abundant organelles and bundles of intermediate-type filaments in the stroma.
authors.affiliation: Department of Obstetrics & Gynecology, Saitama Medical School, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama, 350-0495, and chiba Hokuso Hospital, Japan. somahr99@bj8.so-net.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Soma
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Osawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Oguro
authors.forename: Isao
authors.initials: I
authors.lastname: Yoshihama
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Mineo
authors.forename: Motoshige
authors.initials: M
authors.lastname: Kudo
authors.forename: Kayoko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masumi
authors.initials: M
authors.lastname: Akita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Urabe
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kudo
mesh_terms: D000022:Abortion, Spontaneous / Q000473:pathology; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000473:pathology / Q000648:ultrastructure; D002824:Chorionic Villi / Q000737:chemistry / Q000648:ultrastructure*; D050761:Cyclin-Dependent Kinase Inhibitor p57 / Q000032:analysis*; D018844:Cyclin-Dependent Kinases / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D031901:Gestational Trophoblastic Disease / Q000145:classification* / Q000473:pathology*; D006801:Humans; D006828:Hydatidiform Mole / Q000473:pathology; D007150:Immunohistochemistry; D008648:Mesoderm / Q000473:pathology / Q000648:ultrastructure*; D010928:Placental Lactogen / Q000032:analysis / Q000737:chemistry; D011247:Pregnancy; D002578:Uterine Cervical Dysplasia / Q000196:embryology / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D050761:Cyclin-Dependent Kinase Inhibitor p57; D010928:Placental Lactogen; D018844:Cyclin-Dependent Kinases