Histopathological review of partial and complete hydatidiform moles in a tertiary care hospital, Lahore - Pakistan

ABSTRACT

Hydatidiform mole is an abnormal gestation characterized by trophoblastic hyperplasia and overgrowth of placental villi. Hydatidiform mole is classified as complete [CHM] and partial hydatidiform mole [PHM]. The diagnosis is based on histopathology and genetic origin. The incidence of molar pregnancy varies in different parts of the world. The malignant potential of this disease is higher in south East Asia as compared to western countries. Objective of the present study was to determine the frequency, clinical presentation and morphological features of hydatidiform mole. This retrospective, descriptive case series was conducted in the Department of Pathology Postgraduate Medical Institute and Lahore General Hospital, from 1st Jan 2009 to 31st Dec 2010. The case records of all the molar pregnancy specimens during the study period were analysed regarding patient's history, clinical examination, morphological features and laboratory investigations. The main outcomes were measured in terms of duration, gestational age, morphological features and investigations. A total of 60 cases were examined during the study period, which included 40 cases of complete hydatidiform mole and 20 cases of partial hydatidiform mole. Frequency of CHM was higher as compared to PHM. The disease was common at extremes of ages. Morphological findings of CHM differ from PHM on the basis of degree of trophoblastic hyperplasia, villous contours and scalloping, presence of distinct cisterns and nucleated Red Blood Cells [RBC] in fetal vessels. We concluded that there is no single criterion for the differentiate CHM and PHM. P57[kip2] expression can be used in association with the histological findings for a definite diagnosis