الفهرس 
Introduction
HistologyOnly 14 pages are availabe for public view
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Abstract
Accurate diagnostic classification of hyDROPic placentas (CM, PM, and hyDROPic abortus) is important as the risk of persistent gestational trophoblastic.
This study included 20 cases as complete mole and 20 cases as partial mole and ten cases of products of conception.
In the present work, all 40 cases (100%) of vesicular mole showed trophoblastic hyperplasia. All 20 cases (100%) of CM exhibited circumferential pattern in the majority of villi, while all 20 cases (100%) of PM presented focal hyperplasia. On the contrary, trophoblastic hyperplasia was absent in 9 cases out of 10 (90%) of products of conception, the remaining one case (10%) with a histopathological diagnosis of hyDROPic abortus had focal hyperplasia. Villous edema was present in all 40 cases (100%) of CM and PM. In CM, there was marked generalized villous hyDROPs, while PMs had an admixture of relatively normal immature villi and distended hyDROPic villi with mild villous hyDROPs. Villous edema was absent in 9 cases out of 10 (90%) of products of conception, the remaining one case (10%) with a histopathological diagnosis of hyDROPic abortus had villous edema.
In the present study, the p57 expression was either, nuclear, nuclear and cytoplasmic or cytoplasmic only in cytotrophoblasts. Maternal decidua showed strong nuclear positivity in all cases and served as internal positive control. Seventeen cases out of 20 (85%) of CM lacked immunoreactivity for p57KIP2 in the cytotrophoblasts. The remaining 3 cases of CM (15%) were immunoreactive for p57KIP2 where, 2 cases (66.7%) displayed nuclear expression and one case (33.3%) displayed cytoplasmic expression. Nineteen cases out of 20 (95%) of PM were positive for p57KIP2 in the cytotrophoblasts where, 5 cases (26.5%) displayed nuclear expression, 10 cases (52.6%) displayed nuclear/ cytoplasmic expression and the remaining 4 cases (21.1%) displayed cytoplasmic expression. All 10 cases (100%) of products of conception strongly expressed p57KIP2 in the cytotrophoblasts where, 3 cases (30%) displayed nuclear expression, 5 cases (50%) displayed nuclear/ cytoplasmic expression and 2 (20%) cases displayed cytoplasmic expression.
In complete mole, the Ki-67 labeling index was high in 18 cases out of 20 (90%), and it ranged from 45% to 93% (mean 69.1%±15%). One case (5%) had a low Ki-67 labeling index (16%) and the remaining case (5%) was completely negative. In partial mole, the Ki-67 labeling index was high in 6 cases (30%) and it ranged from 45% to 55% (mean 49.16%±4.26%), low in 12 cases out of 20 (60%) and it ranged from 11% to 38% (mean 21%±8.44%) , and it was completely negative in 2 cases (10%).
In products of conception, 9 cases out of 10 (90%) were completely negative and the remaining one case (10%) that was histopathologically diagnosed as hyDROPic abortus was found to have a low Ki-67 index (25%).
from the results of the previous work, we conclude that:
1- There is no single histopathological criterion for the distinction of CM, PM and products of conception.
2- Absence of p57KIP2 immunostaining is a sensitive and specific finding for diagnosis of CM and can be used in the differential diagnosis of CM from PM. On the other hand, it is useless in differentiating products of conception from PM.
3- Ki-67 proliferative activity is a useful parameter for differential diagnosis of products of conception from PM.
Further studies are recommended based on molecular and genetic basis on p57KIP2 for patients with molar pregnancy and cases with hyDROPic abortus to confirm its role in the differential diagnosis between the three entities (CM, PM, and HA).