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Bartosch C, Nadal A, Braga AC, Salerno A, Rougemont AL, Van Rompuy AS, Fitzgerald B, Joyce C, Allias F, Maher GJ, Turowski G, Tille JC, Alsibai KD, Van de Vijver K, McMahon L, Sunde L, Pyzlak M, Downey P, Wessman S, Patrier S, Kaur B, Fisher R. Practical guidelines of the EOTTD for pathological and genetic diagnosis of hydatidiform moles. Virchows Arch 2024; 484:401-422. [PMID: 37857997 DOI: 10.1007/s00428-023-03658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023]
Abstract
Hydatidiform moles are rare and thus most pathologists and geneticists have little experience with their diagnosis. It is important to promptly and correctly identify hydatidiform moles given that they are premalignant disorders associated with a risk of persistent gestational trophoblastic disease and gestational trophoblastic neoplasia. Improvement in diagnosis can be achieved with uniformization of diagnostic criteria and establishment of algorithms. To this aim, the Pathology and Genetics Working Party of the European Organisation for Treatment of Trophoblastic Diseases has developed guidelines that describe the pathological criteria and ancillary techniques that can be used in the differential diagnosis of hydatidiform moles. These guidelines are based on the best available evidence in the literature, professional experience and consensus of the experts' group involved in its development.
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Affiliation(s)
- Carla Bartosch
- Department of Pathology, Cancer Biology & Epigenetics Group, Research Center of IPO Porto (CI-IPOP) / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC) and Centro Hospitalar Universitário S. João, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal.
| | - Alfons Nadal
- Department of Pathology, Clínic Barcelona, Department of Basic Clinical Practice, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Ana C Braga
- Department of Pathology, University Hospital Centre of São João (CHUSJ) / Faculty of Medicine - University of Porto (FMUP) / School of Health (ESS) - Polytechnic Institute of Porto (P. PORTO), Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Angela Salerno
- Anatomia Patologica, Ospedale Maggiore AUSL Bologna, Bologna, Italy
| | | | | | | | - Caroline Joyce
- Department of Clinical Biochemistry, Cork University Hospital, Ireland/ Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Cork, Ireland
| | - Fabienne Allias
- Department of Pathology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Geoffrey J Maher
- Trophoblastic Tumour Screening & Treatment Centre, Imperial College NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Gitta Turowski
- Department of Pathology, Oslo University Hospital, INNPATH Tirolkliniken, Innsbruck, Austria
| | | | - Kinan Drak Alsibai
- Department of Pathology and Center of Biological Resources (CRB Amazonie), Cayenne Hospital Center Andrée Rosemon, 97306, Cayenne, France
| | | | - Lesley McMahon
- Scottish Hydatidiform Mole Follow-Up Service, Ninewells Hospital and Medical School, Dundee, Scotland
| | - Lone Sunde
- Department of Clinical Genetics, Aalborg University Hospital, Denmark/Department of Biomedicine, Aarhus University, Aalborg, Aarhus, Denmark
| | - Michal Pyzlak
- Department of Pathology, Institute of Mother and Child, Warsaw, Poland
| | - Paul Downey
- Department of Pathology, National Maternity Hospital, Dublin, D02YH21, Ireland
| | - Sandra Wessman
- Department of Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Sophie Patrier
- Department of Pathology, Rouen University Hospital, Rouen, France
| | - Baljeet Kaur
- Department of Pathology, North West London Pathology, Imperial College NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - Rosemary Fisher
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital. Fulham Palace Road, London, W6 8RF, UK
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Eren Karanis MI, Zamani AG. Localized Placental Mesenchymal Dysplasia in Monochorionic Diamniotic Twin Placenta with Beckwith-Wiedemann Syndrome. Fetal Pediatr Pathol 2022; 41:657-664. [PMID: 33356737 DOI: 10.1080/15513815.2020.1865492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
IntroductionPlacental mesenchymal dysplasia (PMD) is often associated with Beckwith-Wiedemann syndrome. Case report: A 27-year-old woman with preeclampsia prematurely delivered twin girls. One side of the placenta was larger with numerous grape-like vesicles, histologically with large, cystic, stem villi with cisterns without syncytiotrophoblastic hyperplasia. This side showed mosaicism for chromosome 11 by FISH and hypomethylation at ICR2 by MLPA. The smaller side of the placenta was normal macroscopically, microscopically, and karyotypically. There was symmetric growth restriction, macroglossia and hypoglycemia of the girl corresponding to the abnormal placental side, and lesser symmetric growth restriction and mild hypoglycemia in the other girl. Conclusion: Localized placental mesenchymal dysplasia can occur in monochorionic diamniotic twin placenta with Beckwith-Wiedemann syndrome. Fetal affects may be asymmetric. PMD can be associated with mosaicism monosomy of chromosome 11.
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Affiliation(s)
| | - Ayse Gül Zamani
- Medical Genetics, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey
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Prenatal Diagnosis of Placental Mesenchymal Dysplasia with 46, X, Isochromosome Xq/45, X Mosaicism. Genes (Basel) 2022; 13:genes13020245. [PMID: 35205290 PMCID: PMC8871973 DOI: 10.3390/genes13020245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Placental mesenchymal dysplasia is an uncommon vascular anomaly of the placenta with characteristics of placentomegaly and multicystic appearance and with or without association with fetal chromosomal anomaly. We present a unique placental mesenchymal dysplasia patient with amniotic fluid karyotyping as 46, X, iso(X) (q10). Detailed molecular testing of the amniotic fluid, fetal cord blood, non-dysplastic placenta and dysplastic placenta was conducted after termination of pregnancy, from which we proved biparental/androgenetic (46, X, i(X) (q10)/45, X) mosaicism in different gestational tissues. A high portion of androgenetic cells in dysplastic placenta (74.2%) and near 100% of biparental cells in the fetus’s blood and amniotic fluid were revealed. Delicate mosaic analyses were performed, and possible pathogenesis and embryogenesis of this case were drawn up.
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Joyce CM, Fitzgerald B, McCarthy TV, Coulter J, O'Donoghue K. Advances in the diagnosis and early management of gestational trophoblastic disease. BMJ MEDICINE 2022; 1:e000321. [PMID: 36936581 PMCID: PMC9978730 DOI: 10.1136/bmjmed-2022-000321] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/21/2022] [Indexed: 12/23/2022]
Abstract
Gestational trophoblastic disease describes a group of rare pregnancy related disorders that span a spectrum of premalignant and malignant conditions. Hydatidiform mole (also termed molar pregnancy) is the most common form of this disease. Hydatidiform mole describes an abnormal conceptus containing two copies of the paternal genome, which is classified as partial when the maternal genome is present or complete when the maternal genome is absent. Hydatidiform mole typically presents in the first trimester with irregular vaginal bleeding and can be suspected on ultrasound but confirmation requires histopathological evaluation of the products of conception. Most molar pregnancies resolve without treatment after uterine evacuation, but occasionally the disease persists and develops into gestational trophoblastic neoplasia. Close monitoring of women after molar pregnancy, with regular measurement of human chorionic gonadotrophin concentrations, allows for early detection of malignancy. Given the rarity of the disease, clinical management and treatment is best provided in specialist centres where very high cure rates are achievable. This review looks at advances in the diagnosis and early management of gestational trophoblastic disease and highlights updates to disease classification and clinical guidelines. Use of molecular genotyping for improved diagnostic accuracy and risk stratification is reviewed and future biomarkers for the earlier detection of malignancy are considered.
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Affiliation(s)
- Caroline M Joyce
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Biochemistry and Cell Biology, University College Cork, Cork, Ireland
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland
| | - Brendan Fitzgerald
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - Tommie V McCarthy
- Department of Biochemistry and Cell Biology, University College Cork, Cork, Ireland
| | - John Coulter
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Keelin O'Donoghue
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
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Carreon CK, Roberts DJ. Discovery of inverted discordant p57 expression in random clusters of dysmorphic chorionic villi of third trimester placentas suggests a more common occurrence of such phenomenon than initially described. Placenta 2020; 104:295-302. [PMID: 33524852 DOI: 10.1016/j.placenta.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Inverted discordant p57 expression in chorionic villi, characterized by a loss of nuclear staining in cytotrophoblast with retained staining in villous stromal cells, is rarely described. Following an incidental finding of such peculiar staining pattern in rare clusters of dysmorphic chorionic villi (DCV) in a perinatal autopsy case, we reviewed our archived cases of third trimester placentas with DCV to systematically analyze these curious foci. METHODS Histopathological features and p57 expression of 26 placentas with DCV were carefully studied by light microscopy and p57 immunohistochemistry. p57 pattern of expression was correlated with a comprehensive list of maternal, fetal, and placental features to reveal potential associations. RESULTS Inverted discordant p57 expression was observed in 17/26 (65.4%) cases, encompassing all cases with aberrant p57 immunostaining in this series. Among the many features investigated, only the focality (occurring as a single focus) of DCV (Fisher's exact test, p = 0.008) and small cluster size of ≤30 villi (Fisher's exact test, p = 0.034) correlated significantly with inverted discordant p57 staining. Other common features of DCV with inverted discordant p57 expression include larger villous size compared with surrounding tertiary villi (13/17, 76.4%), prominent but not hyperplastic and focally to moderately hyperplastic syncytiotrophoblast (17/21, 80.9%), abnormal shapes/irregular contours (17/22, 77.3%), and markedly hypovascular villous stroma (11/17, 64.7%). No distinctive maternal or fetal features were observed. DISCUSSION Inverted discordant p57 expression in DCV of third trimester placentas is likely underreported, and might not be an unusual occurrence outside of suspected molar specimens.
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Affiliation(s)
- Chrystalle Katte Carreon
- Department of Pathology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA; Department of Pathology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA; Department of Pathology, Harvard Medical School, Boston, MA, USA
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Gaillot-Durand L, Patrier S, Aziza J, Devisme L, Riera AC, Marcorelles P, Pelluard F, Gasser B, Mauduit C, Hajri T, Massardier J, Bolze PA, Golfier F, Devouassoux-Shisheboran M, Allias F. p57-discordant villi in hydropic products of conception: a clinicopathological study of 70 cases. Hum Pathol 2020; 101:18-30. [PMID: 32387104 DOI: 10.1016/j.humpath.2020.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
p57 immunostaining is performed on hydropic products of conception to diagnose hydatidiform moles (HMs), which can progress to gestational trophoblastic neoplasia. Partial hydatidiform mole (PHM) and hydropic abortion (HA) display positive staining in stromal and cytotrophoblastic cells, whereas complete hydatidiform mole (CHM) is characterized by loss of p57 expression in both cell types. In some cases, an aberrant pattern is observed, called discordant p57 expression, with positive cytotrophoblast staining and negative stromal staining, or vice versa. The aim of this study was to describe the clinical, biological, and pathological characteristics of p57-discordant villi (p57DV) and other associated populations in cases of divergent p57 expression and to compare the evolutions of p57DV-associated and classic CHMs. Seventy cases of p57DV diagnosed by referent pathologists were divided into two groups, G1: p57DV ± non-CHM component (n = 22) and G2: p57DV + CHM component (n = 48). p57DV morphology was similar in the two groups. Observation of more than two populations and hybrid villi on p57 immunostaining were significantly more frequent in G2. The clinical, ultrasound, and biological presentations of p57DV-associated and classic CHMs were similar. The initial pathological diagnosis was more frequently incorrect, missing the CHM component, for the p57DV-associated CHMs. Molecular genotyping was informative in seven cases and identified as androgenetic/biparental mosaicism in four cases. These results show that p57DV are a diagnostic challenge for pathologists and that most are associated with a CHM component. However, the clinical management of p57DV-associated CHMs should be the same as that of classic CHMs.
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Affiliation(s)
- Lucie Gaillot-Durand
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Sophie Patrier
- Department of Pathology, Rouen University Hospital, Rouen, 76100, France
| | - Jacqueline Aziza
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, University Cancer Institute Toulouse Oncopole, MD Toulouse, 31059, France
| | - Louise Devisme
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Lille University Hospital, Lille, 59000, France
| | - Anne-Claude Riera
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Medipath, Eguilles, 13510, France
| | - Pascale Marcorelles
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Brest University Hospital, Brest, 29200, France
| | - Fanny Pelluard
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Bordeaux University Hospital, Bordeaux, 33000, France
| | - Bernard Gasser
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Mulhouse Hospital, Mulhouse, 68200, France
| | - Claire Mauduit
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France
| | - Touria Hajri
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Jérôme Massardier
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Femme-Mère-Enfants University Hospital, Hospices Civils de Lyon, Bron, 69500, France
| | - Pierre-Adrien Bolze
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - François Golfier
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Mojgan Devouassoux-Shisheboran
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Fabienne Allias
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France.
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7
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Voloshchuk IN, Barinova IV, Chechneva MA, Kovalenko TS, Budykina TS, Aksenov AN, Petrukhin VA. [Placental mesenchymal dysplasia]. Arkh Patol 2019; 81:17-25. [PMID: 31407713 DOI: 10.17116/patol20198104117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To carry out a clinical and morphological analysis of 6 cases of placental mesenchymal dysplasia (PMD) that is not associated with Beckwith-Wiedemann syndrome. MATERIAL AND METHODS Medical records, placental macroscopic and microscopic changes, histochemical (MSB staining) and immunohistochemical studies of placental tissue with antibodies against p57, CD34, smooth muscle actin, desmin, and Ki-67 were analyzed. RESULTS Vascular anomalies in the chorionic plate and stem villi, the increased size and edema of the stem villi during normal formation of the terminal branches of the villous tree, the lack of proliferation of villous trophoblast were the typical signs of PMD and were noted in all cases. Comparison of the results of ultrasonography with the morphological pattern of the disease suggested that there were ultrasound signs that were typical of PMD. The characteristics of the course and outcomes of pregnancy in PMD were given. The features of morphological changes in the presence of PMD concurrent with preeclampsia were found. Significant variability in p57 expression in PMD was shown and variants of changes given. There were no substantial features of the expression of desmin and smooth muscle actin in PMD. CONCLUSION MDP has typical morphological and ultrasound signs. The significant variability in the levels of chorionic gonadotropin and alpha-fetoprotein and in the expression of p57 does not allow their use in the differential diagnosis of PMD. The high incidence of thrombotic events in the intervillous space and fetal vessels, as well as intrauterine growth restriction, intrauterine hypoxia, and an impaired neonatal adaptation period in PMD should be taken into account when determining the management tactics for female patients and newborns.
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Affiliation(s)
- I N Voloshchuk
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - I V Barinova
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - M A Chechneva
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - T S Kovalenko
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - T S Budykina
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - A N Aksenov
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
| | - V A Petrukhin
- Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia
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Gaillot-Durand L, Brioude F, Beneteau C, Le Breton F, Massardier J, Michon L, Devouassoux-Shisheboran M, Allias F. Placental Pathology in Beckwith-Wiedemann Syndrome According to Genotype/Epigenotype Subgroups. Fetal Pediatr Pathol 2018; 37:387-399. [PMID: 30633605 DOI: 10.1080/15513815.2018.1504842] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the frequency of placental pathological lesions in Beckwith-Wiedemann syndrome (BWS), an overgrowth disorder that exhibits etiologic molecular heterogeneity and variable phenotypic expression. MATERIALS AND METHODS The study included 60 BWS patients with a proven molecular diagnosis and a placental pathological examination. Placentomegaly, placental mesenchymal dysplasia (PMD), chorangioma/chorangiomatosis, and extravillous trophoblastic (EVT) cytomegaly were evaluated and their frequencies in the different molecular subgroups were compared. Immunohistochemistry and fluorescent in situ hybridization (FISH) were performed on EVT cytomegaly. RESULTS Placentomegaly was found in 70.9% of cases, PMD in 21.7%, chorangioma/chorangiomatosis in 23.3%, and EVT cytomegaly in 21.7%; there was no significant intergroup difference. EVT cytomegaly showed loss of p57 expression, increased Ki67 proliferating index, and polyploidy on FISH analysis. CONCLUSIONS There was no genotype/epigenotype-phenotype correlation concerning placental lesions in BWS. Diffuse EVT cytomegaly with polyploidy may represent a placental finding suggestive of BWS.
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Affiliation(s)
- Lucie Gaillot-Durand
- a Department of Pathology , Centre hospitalier Lyon Sud , Hospices Civils de Lyon, Pierre Bénite, Lyon , France.,b Société Française de Foetopathologie (SOFFOET) , Rennes , France
| | - Frederic Brioude
- c Département d'Explorations Fonctionnelles Endocriniennes, Sorbonne Université, AP-HP , Hôpitaux Universitaires Paris Est, Hôpital Armand Trousseau, Inserm UMR_S938, Centre de Recherche Saint Antoine , Paris , France
| | - Claire Beneteau
- b Société Française de Foetopathologie (SOFFOET) , Rennes , France.,d Department of Medical Genetics , CHU Nantes , Nantes , France
| | - Frédérique Le Breton
- a Department of Pathology , Centre hospitalier Lyon Sud , Hospices Civils de Lyon, Pierre Bénite, Lyon , France.,b Société Française de Foetopathologie (SOFFOET) , Rennes , France
| | - Jerome Massardier
- b Société Française de Foetopathologie (SOFFOET) , Rennes , France.,e Department of Gynecology and Obstetrics , Hôpital Femme-Mère Enfants, Hospices Civils de Lyon , Bron , France
| | - Lucas Michon
- f Registre des Malformations en Rhône-Alpes (REMERA) , Lyon , France
| | | | - Fabienne Allias
- a Department of Pathology , Centre hospitalier Lyon Sud , Hospices Civils de Lyon, Pierre Bénite, Lyon , France.,b Société Française de Foetopathologie (SOFFOET) , Rennes , France
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9
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Takahashi H, Matsubara S. Letter to 'Placental mesenchymal dysplasia with severe fetal growth restriction in one placenta of a dichorionic diamniotic twin pregnancy': Study on twin placenta as a natural experiment. J Obstet Gynaecol Res 2018; 44:1336-1337. [PMID: 29673004 DOI: 10.1111/jog.13655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
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10
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Genetic and Epigenetic Control of CDKN1C Expression: Importance in Cell Commitment and Differentiation, Tissue Homeostasis and Human Diseases. Int J Mol Sci 2018; 19:ijms19041055. [PMID: 29614816 PMCID: PMC5979523 DOI: 10.3390/ijms19041055] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 03/31/2018] [Accepted: 03/31/2018] [Indexed: 12/28/2022] Open
Abstract
The CDKN1C gene encodes the p57Kip2 protein which has been identified as the third member of the CIP/Kip family, also including p27Kip1 and p21Cip1. In analogy with these proteins, p57Kip2 is able to bind tightly and inhibit cyclin/cyclin-dependent kinase complexes and, in turn, modulate cell division cycle progression. For a long time, the main function of p57Kip2 has been associated only to correct embryogenesis, since CDKN1C-ablated mice are not vital. Accordingly, it has been demonstrated that CDKN1C alterations cause three human hereditary syndromes, characterized by altered growth rate. Subsequently, the p57Kip2 role in several cell phenotypes has been clearly assessed as well as its down-regulation in human cancers. CDKN1C lies in a genetic locus, 11p15.5, characterized by a remarkable regional imprinting that results in the transcription of only the maternal allele. The control of CDKN1C transcription is also linked to additional mechanisms, including DNA methylation and specific histone methylation/acetylation. Finally, long non-coding RNAs and miRNAs appear to play important roles in controlling p57Kip2 levels. This review mostly represents an appraisal of the available data regarding the control of CDKN1C gene expression. In addition, the structure and function of p57Kip2 protein are briefly described and correlated to human physiology and diseases.
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11
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Jitsumori S, Shiro M, Kojima F, Ota N, Minami S, Ino K. Placental mesenchymal dysplasia with severe fetal growth restriction in one placenta of a dichorionic diamniotic twin pregnancy. J Obstet Gynaecol Res 2018; 44:951-954. [DOI: 10.1111/jog.13601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Shoko Jitsumori
- Department of Obstetrics and Gynecology; Wakayama Medical University; Wakayama Japan
| | - Michihisa Shiro
- Department of Obstetrics and Gynecology; Wakayama Medical University; Wakayama Japan
| | - Fumiyoshi Kojima
- Department of Human Pathology and Diagnostic Pathology; Wakayama Medical University; Wakayama Japan
| | - Nami Ota
- Department of Obstetrics and Gynecology; Wakayama Medical University; Wakayama Japan
| | - Sawako Minami
- Department of Obstetrics and Gynecology; Wakayama Medical University; Wakayama Japan
| | - Kazuhiko Ino
- Department of Obstetrics and Gynecology; Wakayama Medical University; Wakayama Japan
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12
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Tanuma A, Kawaguchi RT, Yanagisawa H, Tanaka T, Yanaihara N, Okamoto A. Prenatal imaging and pathology of placental mesenchymal dysplasia: a report of three cases. CASE REPORTS IN PERINATAL MEDICINE 2016. [DOI: 10.1515/crpm-2015-0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Objective: Placental mesenchymal dysplasia (PMD) is a rare vascular anomaly characterized by mesenchymal stem villous hyperplasia. Accurate differential diagnosis of PMD is crucial to predict fetal outcomes associated with serious obstetrical complications.
Methods: We reviewed the clinical and pathological features and immunohistochemical and imaging findings of three patients with PMD.
Results: First trimester sonographic cystic findings identified molar pregnancy or PMD. However, PMD was highly suspected according to the maternal serum human chorionic gonadotropin (hCG) titers, fetal karyotypes, and imaging findings. The outcome of patient 1, in whom placental multicystic areas decreased as pregnancy progressed, was a live birth. In contrast, the babies of patients 2 and 3 were stillborn, and multicystic formations detected during the first trimester completely and consistently occupied the placentas. Pathological and immunohistochemical analyses using anti-CD34 and anti-D2-40 antibodies distinguished the cisternae from multiple small vessels in the villi. Immunohistochemical analyses using anti-CK7 and anti-Ki-67 antibodies did not detect excessive proliferation of trophoblasts. Most abnormal villi associated with PMD comprised stromal cells that did not react with an anti-p57kip2 antibody.
Conclusion: In patients with PMD, if the percentage of the normal placental area decreases as pregnancy progresses, the possibility of fetal growth restriction and intrauterine fetal demise should always be considered. The immunostaining pattern of CD34 and D2-40 may represent a unique feature of PMD and can provide supporting evidence for the differential diagnosis of PMD.
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Allias F, Bolze PA, Gaillot-Durand L, Devouassoux-Shisheboran M. Les maladies trophoblastiques gestationnelles. Ann Pathol 2014; 34:434-47. [DOI: 10.1016/j.annpat.2014.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
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Abstract
Placental mesenchymal dysplasia is a rare placental lesion characterized by stem villous cystic dilation and vesicle formation, placentomegaly, and vascular abnormalities. It can be associated with growth restriction, stillbirth, Beckwith-Wiedemann syndrome, and some chromosomal abnormalities, and needs to be distinguished from its main differential diagnosis, hydatidiform mole.
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Affiliation(s)
- Nogba Pawoo
- From the Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey
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[Placental mesenchymal dysplasia: consequences for the newborn]. Arch Pediatr 2014; 21:998-1001. [PMID: 25048649 DOI: 10.1016/j.arcped.2014.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 03/05/2014] [Accepted: 06/09/2014] [Indexed: 11/23/2022]
Abstract
CASE REPORT We report the case of a newborn presenting with anemia, thrombopenia, intrauterine growth restriction (IUGR), and hepatic hemangioma revealing placental mesenchymal dysplasia. CONCLUSION This rare disease is not always diagnosed during pregnancy. Placental chorioangioma is responsible (in the absence of lethal complications in utero) for IUGR, anemia, neonatal thrombopenia, and hepatic or cutaneous hemangiomas. The early search for hemangiomas with ultrasound scanning could be useful to predict cardiac failure by left-to-right shunt.
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Barut A, Barut F, Kandemir NO, Aktunc E, Arikan I, Harma M, Harma MI, Gun BD. Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis. Gynecol Obstet Invest 2012; 73:141-51. [PMID: 22222282 DOI: 10.1159/000332370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 08/17/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Aykut Barut
- Departments of Gynecology and Obstetrics, Zonguldak Karaelmas University, Kozlu, Zonguldak, Turkey.
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Bourque DK, Peñaherrera MS, Yuen RKC, Van Allen MI, McFadden DE, Robinson WP. The utility of quantitative methylation assays at imprinted genes for the diagnosis of fetal and placental disorders. Clin Genet 2011; 79:169-75. [DOI: 10.1111/j.1399-0004.2010.01443.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Rescue of placental phenotype in a mechanistic model of Beckwith-Wiedemann syndrome. BMC DEVELOPMENTAL BIOLOGY 2010; 10:50. [PMID: 20459838 PMCID: PMC2881899 DOI: 10.1186/1471-213x-10-50] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 05/11/2010] [Indexed: 12/21/2022]
Abstract
Background Several imprinted genes have been implicated in the process of placentation. The distal region of mouse chromosome 7 (Chr 7) contains at least ten imprinted genes, several of which are expressed from the maternal homologue in the placenta. The corresponding paternal alleles of these genes are silenced in cis by an incompletely understood mechanism involving the formation of a repressive nuclear compartment mediated by the long non-coding RNA Kcnq1ot1 initiated from imprinting centre 2 (IC2). However, it is unknown whether some maternally expressed genes are silenced on the paternal homologue via a Kcnq1ot1-independent mechanism. We have previously reported that maternal inheritance of a large truncation of Chr7 encompassing the entire IC2-regulated domain (DelTel7 allele) leads to embryonic lethality at mid-gestation accompanied by severe placental abnormalities. Kcnq1ot1 expression can be abolished on the paternal chromosome by deleting IC2 (IC2KO allele). When the IC2KO mutation is paternally inherited, epigenetic silencing is lost in the region and the DelTel7 lethality is rescued in compound heterozygotes, leading to viable DelTel7/IC2KO mice. Results Considering the important functions of several IC2-regulated genes in placentation, we set out to determine whether these DelTel7/IC2KO rescued conceptuses develop normal placentae. We report no abnormalities with respect to the architecture and vasculature of the DelTel7/IC2KO rescued placentae. Imprinted expression of several of the IC2-regulated genes critical to placentation is also faithfully recapitulated in DelTel7/IC2KO placentae. Conclusion Taken together, our results demonstrate that all the distal chromosome 7 imprinted genes implicated in placental function are silenced by IC2 and Kcnq1ot1 on the paternal allele. Furthermore, our results demonstrate that the methylated maternal IC2 is not required for the regulation of nearby genes. The results show the potential for fully rescuing trans placental abnormalities that are caused by imprinting defects.
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