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Cellular Classification
Gestational trophoblastic tumors may be classified as follows:[1]
- Hydatidiform
mole.
- Invasive mole (chorioadenoma destruens).
- Choriocarcinoma.
- Placental-site trophoblastic tumor.
Hydatidiform mole
Hydatidiform mole is defined as products of conception that lack an intact
fetus and show gross cyst-like swellings of the chorionic villi caused by an
accumulation of fluid. There is disintegration and loss of blood vessels in
the villous core.
Invasive mole
Invasive mole (chorioadenoma destruens) is a locally invasive, rarely
metastatic lesion characterized microscopically by trophoblastic invasion of
the myometrium with identifiable villous structures. Microscopically, this
lesion is characterized by hyperplasia of cytotrophoblastic and syncytial
elements and persistence of villous structures.
Choriocarcinoma
Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. Uterine
muscle and blood vessels are invaded with areas of hemorrhage and necrosis.
Columns and sheets of trophoblastic tissue invade normal tissues and spread to
distant sites, the most common of which are lungs, brain, liver, pelvis,
vagina, spleen, intestines, and kidney.
Placental-site trophoblastic tumor
Placental-site trophoblastic disease is an extremely rare tumor arising from
the placental implantation site and resembles an exaggerated form of syncytial
endometritis. Trophoblastic cells infiltrate the myometrium, and there is
vascular invasion. Human placental lactogen is present in the tumor cells,
while immunoperoxidase staining for human chorionic gonadotropin (hCG) is positive in only scattered cells,
and serum hCG is relatively low.[1]
References
-
Lurain JR: Gestational trophoblastic tumors. Semin Surg Oncol 6 (6): 347-53, 1990.
[PUBMED Abstract]
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