Feature Complete Mole Partial Mole

Karyotype 46,XX (46,XY) Triploid

Villous edema All villi Some villi

Trophoblast proliferation Diffuse; circumferential Focal; slight

Atypia Often present Absent

Serum hCG Elevated Less elevated

HCG in tissue ++++ +

Behavior 2% choriocarcinoma Rare choriocarcinoma

HCG, human chorionic gonadotropin.

Figure 22-63Patterns of fertilization to account for chromosomal origin of complete (46,XX) and triploid partial moles (XXY). In a complete mole, one or two sperm fertilize an egg that

has lost its chromosomes. Partial moles are due to fertilization of an egg by one diploid, or two haploid sperm, depicted in this example as one 23,X and one 23,Y.

Figure 22-64Complete hydatidiform mole suspended in saline showing numerous swollen (hydropic) villi.

Figure 22-65 A, Photomicrograph of partial hydatidiform mole revealing swollen villi and slight hyperplasia of the surface trophoblast. B, Complete hydatidiform mole with extensive

cytotrophoblastic hyperplasia (lower field) (Courtesy of Dr. David R. Genest, Brigham and Women's Hospital, Boston, MA.). C, Complete moles lack expression of p57 in the

cytotrophoblast (arrowheads) and villous stroma (arrow). D, Normal placenta immunostained for p57 exhibits staining in both stromal (arrows) and cytotrophoblast (arrowheads) nuclei.

(Courtesy of Dr. Diego C. Castrillon, Brigham and Women's Hospital, Boston, MA.)

Figure 22-66 A, Invasive mole presenting as a hemorrhagic mass adherent to the uterine wall. B, On cross-section, the tumor invades into the myometrium. (Courtesy of Dr. David R.

Genest, Brigham and Women's Hospital, Boston, MA.)

Figure 22-67 A, Choriocarcinoma presenting as a bulky hemorrhagic mass invading the uterine wall. B, Photomicrograph of choriocarcinoma illustrating both neoplastic cytotrophoblast

and syncytiotrophoblast. (Courtesy of Dr. David R. Genest, Brigham and Women's Hospital, Boston, MA.)

Figure 22-68 A, Placental site trophoblastic tumor, presenting as a discrete mass in the myometrium. B, Histology of PSTT. (Courtesy of Dr. Bradley J. Quade, Brigham and Women's

Hospital, Boston, MA.)

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