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Edited by Ie-Ming Shih, MD, PhD
Division of Gynecologic Pathology
Department of Pathology
Johns Hopkins Medical Institutions
E-mail: ishih@jhmi.edu
Tel: (410) 502-7774
1503 E. Jefferson Street, B-315
Baltimore, MD 21231
Lab website: http://pathology2.jhu.edu/shihlab
Special thanks to Dr. Chih-Yi Hsu for his efforts in photomicrographs and legends
Webmaster; Jennifer Parsons Brumbaugh
Diagnostic pathologists in Gynecological Pathology Division
at the Johns Hopkins Hospital:
Robert J. Kurman, MD, Director
Brigitte Ronnett, MD
Ie-Ming Shih, MD, PhD
Russell Vang, MD
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Hydatidiform Mole
Molar Lesions
- Hydatidiform mole
- Invasive mole
Complete hydatidiform mole
- Round villous outline
- Circumferential proliferation of trophoblast
- villous stromal edema with central cisterns
- Presence of trophoblastic atypia
- Exaggerated implantation site
- 46XX or 46XY
- No embryo
- 10-30% develop GTD
Circumferential proliferation of villous trophoblast with villous edema
Circumferential proliferation of trophoblast with cellular atypia
Circumferential proliferation of trophoblast with villous edema.
In early complete mole the degree of villous trophoblastic hyperplasia may
not be prominent
Partial hydatidiform mole
- admixture of 2 populations of villi (enlarged edematous and normal-sized)
- scalloped villous outline
- circumscribed mild trophoblastic hyperplasia (haphazard tufts)
- Trophoblastic inclusion
- abscence of trophoblastic atypia
- less prominent central cisterns
- result of diandric triploidy
- triploid karyotype
- presence of embryo
- 0.5-4% develop GTD
Invasive mole
- Hydropic villi invade myometrium, vessel or extrauterine sites
- Possible sequela of complete or partial mole
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