《Slide 77.》Hydatidiform mole, Endometrium

A. Brief Descriptions:

1. Benign, noninvasive gestational trophoblastic disease (GTD), characterized by cystic swelling of the chorionic villi with variable trophoblastic proliferation.

2. Most patients present in the fourth or fifth month of pregnancy with vaginal bleeding.

B. Gross Findings:

1. The uterus usually larger than the stage of pregnancy.

2. The uterine cavity is filled with a delicate friable mass of thin-walled, cystic, grape-like structures.

C. Micro Findings:

1. Hydropic swelling of chorionic villi.

2. Loose and myxomatous stroma with absence of vascularization of villi.

3. Proliferation of trophoblasts.

4. Severe hemorrhage.

D. Others:

   DDx:

   1. Complete mole: all or most of the villi are edematous + diffuse trophoblastic hyperplasia.

   2. Partial mole: some villi are edematous + focal trophoblastic hyperplasia.

E. Reference:

1. Robbins Pathologic Basis of Disease, 6^th ed.  P.1085-1087.

 

 

【 Fig. 77-1 (LP)】.Edematous villi and hyperplastic trophoblasts.

　

 

 

【 Fig. 77-2 (LP)】.Hydropic villi and hyperplastic trophoblasts.

　

 

 

【 Fig. 77-3 (HP)】.Hydropic swelling of chorionic villi with absence or inadequate development of vascularization.

　

 

 

【 Fig. 77-4 (LP)】.Sheets and masses of trophoblasts.