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Case Reports
. 2021 Jan 28:8:2374289520987256.
doi: 10.1177/2374289520987256. eCollection 2021 Jan-Dec.

Educational Case: Hydatidiform Molar Pregnancy

Anna Lepore  1 , Richard M Conran  1
Affiliations
Case Reports

Educational Case: Hydatidiform Molar Pregnancy

Anna Lepore et al. Acad Pathol. .

Abstract

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.1.

Keywords: complete molar pregnancy; female reproductive disorders; gestational trophoblastic disease; hydatidiform mole; organ system pathology; pathology competencies; pregnancy; vaginal bleeding.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Transverse image of complete hydatidiform mole on ultrasonography. Note the complex intrauterine mass of tissue with cystic spaces (CM). This finding is referred to as a “snowstorm” pattern, sonographically.
Figure 2.
Figure 2.
Complete hydatidiform mole. The uterine curettings immersed in water demonstrate uniform dilation of the chorionic villi.
Figure 3.
Figure 3.
Complete hydatidiform mole. There is prominent trophoblast hyperplasia (*) composed of cytotrophoblast and syncytiotrophoblast circumferentially surrounding the chorionic villi (V). H&E, intermediate power.
Figure 4.
Figure 4.
Complete hydatidiform mole. The chorionic villi (V) are uniformly dilated with prominent central cisterns and circumferential trophoblast hyperplasia (*). H&E, low power.
Figure 5.
Figure 5.
Complete hydatidiform mole. The trophoblast hyperplasia consists of cytotrophoblast (C) and syncytiotrophoblast (S). H&E, intermediate power.
Figure 6.
Figure 6.
Complete hydatidiform mole. This hysterectomy specimen shows the uterine cavity filled with uniformly dilated chorionic villi (*). No fetal tissue is present.
Figure 7.
Figure 7.
Complete hydatidiform mole. A section from a hysterectomy specimen shows uniform dilation of villi (*) attached to the myometrium (M). H&E, low power.
Figure 8.
Figure 8.
Partial hydatidiform mole. There is a dual population of chorionic villi. A large villus with cistern (C) is intermixed with more normal size and fibrotic villi (*). H&E, intermediate power.
Figure 9.
Figure 9.
Partial hydatidiform mole. A large villus with scalloped contour (arrowheads), trophoblast inclusions (*), and cistern (C) is present. An adjacent villus with trophoblast hyperplasia is also seen (arrow). H&E, intermediate magnification.
Figure 10.
Figure 10.
Choriocarcinoma. A hysterectomy specimen shows a large hemorrhagic mass in the uterine corpus (arrowheads).
Figure 11.
Figure 11.
Choriocarcinoma. The classic biphasic pattern of syncytiotrophoblast (S) and cytotrophoblast (C) with cytological atypia and hemorrhage (*) is present. Chorionic villi are absent. H&E, intermediate power.
See this image and copyright information in PMC

References

    1. Knollmann-Ritschel BEC, Regula DP, Borowitz MJ, Conran R, Prystowsky MB. Pathology competencies for medical education and educational cases. Acad Pathol. 2017:4 doi:10.1177/2374289517715040 - PMC - PubMed
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