A. Gschwendtner et al., DNA-PLOIDY DETERMINATION OF EARLY MOLAR PREGNANCIES BY IMAGE-ANALYSIS- COMPARISON TO HISTOLOGIC CLASSIFICATION, Archives of pathology and laboratory medicine, 122(11), 1998, pp. 1000-1004
Citations number
22
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Background.-To improve histologic diagnosis of molar pregnancies, upda
ted guidelines have been proposed recently. These guidelines take into
account that less developed molar gestations differ from their fully
developed counterparts. Objective.-To test the validity of these crite
ria by correlating histologic diagnosis with ploidy determination acco
mplished by means of image analysis. Design.-Fifty archival cases of e
arly molar pregnancy were reclassified according to the new criteria.
The diagnosis had to be changed from partial to complete hydatidiform
mole (PM to CM, respectively) in 9 cases and from CM to PM in 4 cases.
DNA image cytometry could be performed in 40 cases (CM, n = 21; PM, n
= 99). Results.-There was 100% agreement between histologic diagnosis
and a diploid or polyploid histogram in CM and 79% agreement between
triploidy and PM, when the updated diagnostic criteria were used. This
represents an improvement compared with diagnoses made with former cr
iteria. Nevertheless, problems of correct classification remain: In 3
cases classified as PMs, fetal remnants were accompanied by the histol
ogic appearance of a CM, These 3 cases could represent either a true e
mbryonic development in CM or a twin gestation with one normal pregnan
cy and one mole, or they could belong to a (very rare) third type of m
ole. All of them show the same risk of persistent trophoblastic: disea
se observed in classic CM. Conclusions.-As the groups at risk for deve
loping persistent trophoblastic disease can be identified by their DNA
histograms, ploidy analysis would be desirable in addition to histolo
gic examination.