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Mendoza RP, Doytcheva K, Ud Dean M, Jorgenson KM, Choi D, Segal J, Wang P, Lastra RR. Whole exome sequencing of placental chorangioma. Placenta 2024; 149:13-17. [PMID: 38484495 DOI: 10.1016/j.placenta.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION Placental chorangioma is a benign non-trophoblastic vascular proliferation of the placental chorion favored to represent hamartoma-like or hyperplastic capillary lesions. As the exact pathophysiology has not been established, we investigated the molecular characteristics of placental chorangiomas using exploratory whole exome sequencing. METHODS Three cases were retrospectively selected and whole exome sequencing was performed on macrodissected lesions. DNA extraction, DNA quantification, library preparation and sequencing were performed with IDT xGen™ Exome Hybridization Panel v2 for library capture. Sequencing data was analyzed with an in-house bioinformatics pipeline for single-nucleotide variants and insertions/deletions. RESULTS All neonates were delivered at term and had birth weights ranging from 11th-35th percentile for gestational age. All mothers presented with hypertensive disorder during pregnancy. Chorangiomas ranged from 0.7 cm to 5.1 cm and were well-circumscribed near the fetal surface. Case 1 showed a background of chorangiosis and acute subchorionitis, while case 2 had foci of chronic lymphocytic villitis. Whole exome sequencing did not reveal any significant pathologic variants. DISCUSSIONS The absence of molecular alteration in placental chorangioma is likely indicative of the reactive/non-neoplastic nature of this lesion. The presence of compromised blood flow in the form of hypertensive disorders in our cases may be one of its underlying pathophysiologic mechanisms.
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Affiliation(s)
- Rachelle P Mendoza
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Kristina Doytcheva
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Minhaz Ud Dean
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Kyla M Jorgenson
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Donghyuk Choi
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Jeremy Segal
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Peng Wang
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Ricardo R Lastra
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA.
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Stabile G, Scalia MS, Stampalija T, Bruno M, Laganà AS, Sartore A, Mangogna A, Carlucci S. Placental Chorangiocarcinoma a Specific Histological Pattern of Uncertain Incidence and Clinical Impact: Systematic Review of the Literature. J Clin Med 2023; 12:jcm12093065. [PMID: 37176506 PMCID: PMC10179247 DOI: 10.3390/jcm12093065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Chorangiocarcinoma is a very rare and misdiagnosed placental neoplasm. The unique morphologic features of the lesion distinguish it from other trophoblastic tumors and vascular abnormalities. We present a systematic review of the literature to provide clarity on chorangiocarcinoma entity and biology. A literature search was carried out in December 2022 using the keywords "Placental chorangiocarcinoma", "Chorangioma", "Placenta", and "Throphoblast proliferation". Articles published from 1988 to 2022 were obtained from Scopus, Google Scholar, and PUBMED. In our review, we examined maternal age, gestational age at the time of delivery, parity, type of pregnancy, placental weight, ultrasound features of the placenta, macroscopic examination and tumor size, microscopic examination, immunostaining, maternal beta-human chorionic gonadotropin, fetal and maternal outcome. Eight manuscripts were detected. They are all case reports. The macroscopic characteristics of the lesions were represented by the presence of a grey-yellow-white color well-demarcated round nodule. Microscopically, all the authors described typical aspects of malignancy as a high rate of mitosis, nuclear atypia and necrotic areas. In some cases, the presence of AE1/AE3 cytoplasmic positivity, p63 nuclear staining, and beta-human chorionic gonadotropin (BHCG) were reported. A good fetal outcome was reported in all cases of newborns with normal birth weight, except one with fetal growth restriction. Maternal outcome was good in all cases except one with maternal lung metastasis three months after delivery. The clinical course has probably underestimated the real incidence of the pathology. Only greater knowledge of its histology and its clinical course will allow us to evaluate the real prevalence of the disease.
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Affiliation(s)
- Guglielmo Stabile
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
| | - Maria Sole Scalia
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Tamara Stampalija
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Matteo Bruno
- Unit of Obstetrics and Gynecology, San Salvatore Hospital, 67100 L'Aquila, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Andrea Sartore
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
| | - Alessandro Mangogna
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
| | - Stefania Carlucci
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
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Iwahata H, Iwahata Y, Homma C, Kurasaki A, Hasegawa J, Suzuki N. Degenerative type of placental chorioangioma requiring fetal blood transfusion. J Obstet Gynaecol Res 2021; 47:1191-1194. [PMID: 33522070 DOI: 10.1111/jog.14685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/03/2021] [Accepted: 01/16/2021] [Indexed: 11/30/2022]
Abstract
We experienced a case with fetal hydrops, polyhydramnios, and a well-defined oval anechoic lesion of approximately 9 cm in size, without blood flow at 26 weeks' gestation. As increased middle cerebral artery peak systolic velocity, the fetal hydrops was caused by a placental tumor such as a chorioangioma; however, the tumor was atypical. Fetal blood hemoglobin was 8.3 g/dl on percutaneous umbilical cord blood sampling. After erythrocytes transfusion to the fetus, the mother normally delivered at 38 weeks' gestation. The placental tumor was histologically diagnosed as a necrotic chorioangioma. Obstetricians should note such atypical chorioangiomas when differential diagnosis of placental tumors.
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Affiliation(s)
- Hideyuki Iwahata
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuriko Iwahata
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Chika Homma
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Akiko Kurasaki
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Junichi Hasegawa
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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Akbarzadeh-Jahromi M, Soleimani N, Mohammadzadeh S. Multiple Chorangioma Following Long-Term Secondary Infertility: A Rare Case Report and Review of Pathologic Differential Diagnosis. Int Med Case Rep J 2019; 12:383-387. [PMID: 31908545 PMCID: PMC6927595 DOI: 10.2147/imcrj.s227947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/12/2019] [Indexed: 12/04/2022] Open
Abstract
Chorangioma (placental hemangioma) is a benign non-trophoblastic neoplasm of the placenta. Small chorangiomas are usually asymptomatic, but the giant and multiple ones rarely have a favorable outcome. We report a case of 29 weeks of gestational age (after long-term secondary infertility) with premature labor pain and undiagnosed multiple chorangioma leading to hydrops fetalis and neonatal death. Here we report the clinicopathological features of our case and chorangioma in general, along with comparison of different vascular lesions of placenta in terms of incidence, risk factors, complications, histologic origin, macroscopic and light and electron microscopic features.
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Affiliation(s)
| | - Neda Soleimani
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
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Allias F, Lebreton F, Gaillot-Durand L, Jaouen A, Reis Borges R, Devouassoux-Shisheboran M. [Pseudosarcomatous chorangioma: A macroscopic and microscopic atypical tumor]. Ann Pathol 2016; 36:120-4. [PMID: 26993586 DOI: 10.1016/j.annpat.2015.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/19/2015] [Accepted: 11/12/2015] [Indexed: 11/16/2022]
Abstract
We report a case of an unusual chorangioma in a 26-year-old gravida 2, para 1 female. The clinical course was complicated by premature birth at 34 weeks' gestation. The baby presented with congenital cardiac and renal malformations. The tumor was 11 cm in size, separated from the main placental mass and exhibited atypical histologic characteristics such as fibromatous areas, high cellularity, nuclear atypia and high mitotic index. These histologic features must not be interpreted as malignancy.
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Affiliation(s)
- Fabienne Allias
- Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
| | - Frédérique Lebreton
- Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - Lucie Gaillot-Durand
- Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - Alexandre Jaouen
- Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - Ruth Reis Borges
- Centre de pathologie, 31, avenue du Général-de-Gaule, BP 32, 26201 Montélimar cedex, France
| | - Mojgan Devouassoux-Shisheboran
- Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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Bruner ET. Pseudotumors of the placenta. Semin Diagn Pathol 2015; 33:43-9. [PMID: 26603594 DOI: 10.1053/j.semdp.2015.09.006] [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: 11/11/2022]
Abstract
The placenta is one of the most common gross pathology specimens encountered by surgical pathologists, yet primary tumors are exceptionally rare and even rarer are entities with the potential to mimic malignancy. There are many nonneoplasticmass forming lesions in the placenta that are important to be aware of as many of these can be associated with adverse outcomes in the mother and fetus. Also important are entities which may be observed microscopically in the placenta and potentially confused as a malignancy. Knowledge of these potential pitfalls is essential to avoid making an incorrect diagnosis and causing undue alarm.
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Affiliation(s)
- Evelyn T Bruner
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 171 Ashley Ave, MSC 908, Charleston, South Carolina 29425-9080.
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