H-mole
I. INTRODUCTION
Hydatidiform Mole (H-mole or Gestational trophoblastic disease) is abnormal proliferation and then degeneration of the trophoblastic villi (Garg & Giuntoli, 2007). As the cells degenerate, they become filled with fluid and appear as clear fluid-filled, grape-sized vesicles. The embryo fails to develop beyond a primitive start. Abnormal trophoblast cells must be identified because they are associated with choriocarcinoma, a rapidly metastasizing malignancy. (Pillitteri, 2010)
Figure 1. Gestational trophoblastic disease (hydatidiform mole). (From Rubin, E., & Farber, J. L. [1994]. Pathology [2nd ed.]. Philadelphia: JB Lippincott.)
The incidence of gestational trophoblastic disease is approximately 1 in every 1500 pregnancies. The condition tends to occur most often in women who have a low protein intake, in women older than age 35 years, in women of Asian heritage, and in blood group A women who marry blood group O men (Aghajanian, 2007).
Two types of molar growth can be identified by chromosome analysis. With a complete mole, all trophoblastic villi swell and become cystic. If an embryo forms, it dies early at only 1 to 2 mm in size, with no fetal blood present in the villi. On chromosomal analysis, although the karyotype is a normal 46XX or 46XY, this chromosome component was contributed only by the father or an “empty ovum” was fertilized and the chromosome material was duplicated. (Pillitteri, 2010)
With a partial mole, some of the villi form normally. The syncytiotrophoblastic layer of villi, however, is swollen and misshapen. A macerated embryo of approximately 9 weeks’ gestation may be present and fetal blood may be present in the villi. A partial mole has 69 chromosomes (a triploid formation in which there are three chromosomes instead of two for every pair, one set supplied by an ovum that apparently was fertilized by two sperm or an ovum fertilized by one sperm in which meiosis or reduction division did not
Hydatidiform Mole (H-mole or Gestational trophoblastic disease) is abnormal proliferation and then degeneration of the trophoblastic villi (Garg & Giuntoli, 2007). As the cells degenerate, they become filled with fluid and appear as clear fluid-filled, grape-sized vesicles. The embryo fails to develop beyond a primitive start. Abnormal trophoblast cells must be identified because they are associated with choriocarcinoma, a rapidly metastasizing malignancy. (Pillitteri, 2010)
Figure 1. Gestational trophoblastic disease (hydatidiform mole). (From Rubin, E., & Farber, J. L. [1994]. Pathology [2nd ed.]. Philadelphia: JB Lippincott.)
The incidence of gestational trophoblastic disease is approximately 1 in every 1500 pregnancies. The condition tends to occur most often in women who have a low protein intake, in women older than age 35 years, in women of Asian heritage, and in blood group A women who marry blood group O men (Aghajanian, 2007).
Two types of molar growth can be identified by chromosome analysis. With a complete mole, all trophoblastic villi swell and become cystic. If an embryo forms, it dies early at only 1 to 2 mm in size, with no fetal blood present in the villi. On chromosomal analysis, although the karyotype is a normal 46XX or 46XY, this chromosome component was contributed only by the father or an “empty ovum” was fertilized and the chromosome material was duplicated. (Pillitteri, 2010)
With a partial mole, some of the villi form normally. The syncytiotrophoblastic layer of villi, however, is swollen and misshapen. A macerated embryo of approximately 9 weeks’ gestation may be present and fetal blood may be present in the villi. A partial mole has 69 chromosomes (a triploid formation in which there are three chromosomes instead of two for every pair, one set supplied by an ovum that apparently was fertilized by two sperm or an ovum fertilized by one sperm in which meiosis or reduction division did not