임심 초기의 완전 포상기태:51예의 임상 및 병리학적 소견
Complete Hydatidiform Mole in Early Gestation:A Clinicopathologic Study of 51 Cases
김규래, 이승구, 전선영, 박소영,
소속 상세정보
김규래 ( Kim Kyu-Rae )
울산대학교 의과대학 서울중앙병원 진단병리학교실
이승구 ( Lee Seung-Koo )
울산대학교 의과대학 서울중앙병원 진단병리학교실
전선영 ( Jun Sun-Young )
울산대학교 의과대학 서울중앙병원 진단병리학교실
박소영 ( Park So-Young )
강서미즈메디병원 병리과
KMID : 0357920020360020093
Abstract
Background: With the widespread use of high resolution in early pregnancy periods, poorly formed diagnostic features of complete hydatidiform mole (CHM) (which mimics normal or nonmolar gestation) often lead to a confusion of CHM with partial mole, hydropic abortion or nonmolar chromosomal abnormalities.
Methods: We studied the clinicopathologic findings in 51 early CHM, evaucated before 12 weeks of gestation to characterize the early histologic changes.
Results: Conventional diagnostic features were not uniformly identified; extensive cavitation was identified in 51.0%, trophoblastic hyperplasia in 49.1%, and avascular villi in 13.7%. The characteristic histologic features of early CHM were cellular and basophilic stroma (82.4%), bulbous projection with linear intervening clefts (76.5%), and apoptotic stromal cells (84.3%). In 86.3%, vascularized chorionic villi showed either primitive vascular network or clearly visible vascular lumen. Nomentastatic persistent trophoblastic neoplasia developed in 35.3% and all were cured with single-agent or combination chemotherapy. Choriocarcinoma did not develop in any cases. The extent of trophoblastic prolferation at initial curettage had no prognostic value for clinical progressio to persistent hydatidiform mole.
Conclusions: The fact that the histologic features of CHM in early gestation are often notas distinctive as those in laster gestation should always be kept in mind in the diagnosis of conceptual products in early gestation.
키워드
Hydatidiform Mole;Pregnancy;Chorionic Vili;Blood Vessels
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