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Pathology Atlas: Gestational Trophoblastic Disease

Hydatidiform Mole

In situ hydatidiform mole in hysterectomy specimen. The dilated vesicles are apparent. The outer membranes surrouding each of these vesicles are made up of the trophoblastic layer.

Microscopic view of hydatidiform mole with a low order of trophoblastic proliferation. Edema of the villus stroma and loss of vascular support are evident. Despite the low activity of the trophoblast from this tissue, the patient from whom this was taken developed metastatic choriocarcinoma.

Microscopic view of hydatidiform mole showing moderate trophoblastic proliferation along with the other usually seen histopathologic signs. This patient developed invasive mole.

Histopathologic view of hydatidiform mole evacuated by curettage. In this particular view only the trophoblast is apparent, the underlying villus being outside this field. There is moderate to severe trophoblastic proliferation, but this patient was cured by uterine evacuation alone.

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Invasive Mole

Uterus containing invasive hydatidiform mole (chorioadenoma destruens). The nodule of disease is high in the uterine fundus, and on careful inspection several dilated vesicles can be seen in the myometrium.

Microscopic view of invasive mole (chorioadenoma destruens), showing retention of the villus pattern and trophoblastic proliferation deep in the myometrium. This section was taken from the uterus shown in Figure 6.

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Partial Mole

Microscopic view of partial hydatidiform mole. Left. At the upper edge is a large central cistern. Smaller villi show edema and various degrees of scalloping. The fetus was alive. Trophoblastic hyperplasia was inconspicuous but present. Right. The wall of a large cistern formed in the presence of a functioning fetoplacental circulation. Note patent, well-formed villous vessels filled with fetal erythrocytes.(Sulzman A, Buchsbaum HJ: Gestational trophoblastic disease. In Clinical Perspectives in Obstetrics and Gynecology, p. 38. New York, Springer-Verlag, 1987.

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Uterus removed for choriocarcinoma. The extensive necrosis, vascular penetration, and hemorrhage are evident from this specimen.

Microscopic view of choriocarcinoma taken from the uterus illustrated in Figure 9. Sheets of anaplastic trophoblastic cells are noted without the maintenance of the pattern of the villi. Extensive necrosis is evident.

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