Prevalence and significance of implantation site trophoblastic atypia in hydatidiform moles and spontaneous abortions

American Journal of Clinical Pathology
M MontesD R Genest

Abstract

The authors studied the prevalence and significance of implantation site trophoblastic atypia in hydatidiform moles and spontaneous abortions. Three pathologists independently categorized 99 early abortion specimens regarding diagnosis (spontaneous abortion, partial hydatidiform mole, complete hydatidiform mole); qualitative atypia of implantation site trophoblast (absent, mild, moderate-severe); and quantitative atypia of implantation site trophoblast (absent, focal, diffuse). Interobserver agreement was good to excellent regarding diagnosis (kappa 0.66-0.79) and poor to fair regarding qualitative atypia of implantation site trophoblast (kappa 0.20-0.43). By consensus diagnosis, implantation site trophoblastic atypia was mild and focal in 5% of 22 spontaneous abortions; predominantly focal in 40% of 30 partial moles (33% mild atypia; 7% moderate-severe atypia); and, predominantly diffuse in 87% of 47 complete moles (21% mild atypia; 66% moderate-severe atypia). Among hydatidiform moles, the subsequent development of persistent gestational trophoblastic tumor did not relate to the degree of implantation site trophoblastic atypia. The authors conclude that trophoblast of the implantation site exhibits focal, mild atypia in some ...Continue Reading

Citations

Dec 5, 1996·The New England Journal of Medicine·R S Berkowitz, D P Goldstein
Dec 25, 2012·Virchows Archiv : an International Journal of Pathology·Isabella GrinschglBarbara Guertl
Apr 17, 2009·The New England Journal of Medicine·Ross S Berkowitz, Donald P Goldstein
Sep 19, 2003·Gynecologic Oncology·Lawrence S AmesseTeresa Pfaff-Amesse
Nov 15, 2003·Best Practice & Research. Clinical Obstetrics & Gynaecology·Annie Nga-Yin Cheung

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