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Placental Mesenchymal Dysplasia and Beckwith-Wiedemann Syndrome. Cancers (Basel) 2022; 14:cancers14225563. [PMID: 36428656 PMCID: PMC9688415 DOI: 10.3390/cancers14225563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Placental mesenchymal dysplasia (PMD) is characterized by placentomegaly, aneurysmally dilated chorionic plate vessels, thrombosis of the dilated vessels, and large grapelike vesicles, and is often mistaken for partial or complete hydatidiform mole with a coexisting normal fetus. Androgenetic/biparental mosaicism (ABM) has been found in many PMD cases. Beckwith-Wiedemann syndrome (BWS) is an imprinting disorder with complex and diverse phenotypes and an increased risk of developing embryonal tumors. There are five major causative alterations: loss of methylation of imprinting control region 2 (KCNQ1OT1:TSS-DMR) (ICR2-LOM), gain of methylation at ICR1 (H19/IGF2:IG-DMR) (ICR1-GOM), paternal uniparental disomy of 11 (pUPD11), loss-of-function variants of the CDKN1C gene, and paternal duplication of 11p15. Additional minor alterations include genetic variants within ICR1, paternal uniparental diploidy/biparental diploidy mosaicism (PUDM, also called ABM), and genetic variants of KCNQ1. ABM (PUDM) is found in both conditions, and approximately 20% of fetuses from PMD cases are BWS and vice versa, suggesting a molecular link. PMD and BWS share some molecular characteristics in some cases, but not in others. These findings raise questions concerning the timing of the occurrence of the molecularly abnormal cells during the postfertilization period and the effects of these abnormalities on cell fates after implantation.
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Eren Karanis MI, Zamani AG. Localized Placental Mesenchymal Dysplasia in Monochorionic Diamniotic Twin Placenta with Beckwith-Wiedemann Syndrome. Fetal Pediatr Pathol 2022; 41:657-664. [PMID: 33356737 DOI: 10.1080/15513815.2020.1865492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
IntroductionPlacental mesenchymal dysplasia (PMD) is often associated with Beckwith-Wiedemann syndrome. Case report: A 27-year-old woman with preeclampsia prematurely delivered twin girls. One side of the placenta was larger with numerous grape-like vesicles, histologically with large, cystic, stem villi with cisterns without syncytiotrophoblastic hyperplasia. This side showed mosaicism for chromosome 11 by FISH and hypomethylation at ICR2 by MLPA. The smaller side of the placenta was normal macroscopically, microscopically, and karyotypically. There was symmetric growth restriction, macroglossia and hypoglycemia of the girl corresponding to the abnormal placental side, and lesser symmetric growth restriction and mild hypoglycemia in the other girl. Conclusion: Localized placental mesenchymal dysplasia can occur in monochorionic diamniotic twin placenta with Beckwith-Wiedemann syndrome. Fetal affects may be asymmetric. PMD can be associated with mosaicism monosomy of chromosome 11.
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Affiliation(s)
| | - Ayse Gül Zamani
- Medical Genetics, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey
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Aoki S, Higashimoto K, Hidaka H, Ohtsuka Y, Aoki S, Mishima H, Yoshiura KI, Nakabayashi K, Hata K, Yatsuki H, Hara S, Ohba T, Katabuchi H, Soejima H. Aberrant hypomethylation at imprinted differentially methylated regions is involved in biparental placental mesenchymal dysplasia. Clin Epigenetics 2022; 14:64. [PMID: 35581658 PMCID: PMC9115938 DOI: 10.1186/s13148-022-01280-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Placental mesenchymal dysplasia (PMD) is a morphological abnormality resembling partial hydatidiform moles. It is often associated with androgenetic/biparental mosaicism (ABM) and complicated by Beckwith-Wiedemann syndrome (BWS), an imprinting disorder. These phenomena suggest an association between PMD and aberrant genomic imprinting, particularly of CDKN1C and IGF2. The existence of another type of PMD containing the biparental genome has been reported. However, the frequency and etiology of biparental PMD are not yet fully understood. RESULTS We examined 44 placental specimens from 26 patients with PMD: 19 of these were macroscopically normal and 25 exhibited macroscopic PMD. Genotyping by DNA microarray or short tandem repeat analysis revealed that approximately 35% of the macroscopic PMD specimens could be classified as biparental, while the remainder were ABM. We performed a DNA methylation analysis using bisulfite pyrosequencing of 15 placenta-specific imprinted differentially methylated regions (DMRs) and 36 ubiquitous imprinted DMRs. As expected, most DMRs in the macroscopic PMD specimens with ABM exhibited the paternal epigenotype. Importantly, the biparental macroscopic PMD specimens exhibited frequent aberrant hypomethylation at seven of the placenta-specific DMRs. Allelic expression analysis using single-nucleotide polymorphisms revealed that five imprinted genes associated with these aberrantly hypomethylated DMRs were biallelically expressed. Frequent aberrant hypomethylation was observed at five ubiquitous DMRs, including GRB10 but not ICR2 or ICR1, which regulate the expression of CDKN1C and IGF2, respectively. Whole-exome sequencing performed on four biparental macroscopic PMD specimens did not reveal any pathological genetic abnormalities. Clinical and molecular analyses of babies born from pregnancies with PMD revealed four cases with BWS, each exhibiting different molecular characteristics, and those between BWS and PMD specimens were not always the same. CONCLUSION These data clarify the prevalence of biparental PMD and ABM-PMD and strongly implicate hypomethylation of DMRs in the pathogenesis of biparental PMD, particularly placenta-specific DMRs and the ubiquitous GRB10, but not ICR2 or ICR1. Aberrant hypomethylation of DMRs was partial, indicating that it occurs after fertilization. PMD is an imprinting disorder, and it may be a missing link between imprinting disorders and placental disorders incompatible with life, such as complete hydatidiform moles and partial hydatidiform moles.
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Affiliation(s)
- Saori Aoki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Ken Higashimoto
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
| | - Hidenori Hidaka
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
| | - Yasufumi Ohtsuka
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
| | - Shigehisa Aoki
- Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Hitomi Yatsuki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
| | - Satoshi Hara
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan
| | - Takashi Ohba
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Hidenobu Soejima
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
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A Challenging Diagnosis: Placental Mesenchymal Dysplasia—Literature Review and Case Report. Diagnostics (Basel) 2022; 12:diagnostics12020293. [PMID: 35204384 PMCID: PMC8871501 DOI: 10.3390/diagnostics12020293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
We describe a 22-year-old woman (2-gravid) case who was referred to our clinic at 18 weeks of gestation for a placenta with vesicular lesions discovered on prenatal examination routine. An ultrasound exam at 31 weeks of gestation showed numerous vesicular lesions, which gradually augmented as the pregnancy advanced. A live normal-appearing fetus was confirmed by intrauterine growth restriction (IUGR). The maternal serum β-human chorionic gonadotropin level remained in normal ranges. At some point, a multidisciplinary medical consensus considered the termination of the pregnancy, but the patient refused to comply. At 33 weeks of gestation, preterm premature rupture of membranes (pPROM) occurred, and she spontaneously delivered a 1600 g healthy female baby with a good long-term outcome. Placental mesenchymal dysplasia (PMD) was retrospectively diagnosed after confronting the data from ultrasound, chorionic villus sampling (CVS), amniocentesis, pathological examination, and immunohistochemical stain. The lack of sufficient reports of PMD determines doctors to be cautious and reserved, approaching these cases more radically than necessary. We reviewed this disease and searched for all cases of PMD associated with healthy, live newborns.
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Gaillot-Durand L, Patrier S, Aziza J, Devisme L, Riera AC, Marcorelles P, Pelluard F, Gasser B, Mauduit C, Hajri T, Massardier J, Bolze PA, Golfier F, Devouassoux-Shisheboran M, Allias F. p57-discordant villi in hydropic products of conception: a clinicopathological study of 70 cases. Hum Pathol 2020; 101:18-30. [PMID: 32387104 DOI: 10.1016/j.humpath.2020.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
p57 immunostaining is performed on hydropic products of conception to diagnose hydatidiform moles (HMs), which can progress to gestational trophoblastic neoplasia. Partial hydatidiform mole (PHM) and hydropic abortion (HA) display positive staining in stromal and cytotrophoblastic cells, whereas complete hydatidiform mole (CHM) is characterized by loss of p57 expression in both cell types. In some cases, an aberrant pattern is observed, called discordant p57 expression, with positive cytotrophoblast staining and negative stromal staining, or vice versa. The aim of this study was to describe the clinical, biological, and pathological characteristics of p57-discordant villi (p57DV) and other associated populations in cases of divergent p57 expression and to compare the evolutions of p57DV-associated and classic CHMs. Seventy cases of p57DV diagnosed by referent pathologists were divided into two groups, G1: p57DV ± non-CHM component (n = 22) and G2: p57DV + CHM component (n = 48). p57DV morphology was similar in the two groups. Observation of more than two populations and hybrid villi on p57 immunostaining were significantly more frequent in G2. The clinical, ultrasound, and biological presentations of p57DV-associated and classic CHMs were similar. The initial pathological diagnosis was more frequently incorrect, missing the CHM component, for the p57DV-associated CHMs. Molecular genotyping was informative in seven cases and identified as androgenetic/biparental mosaicism in four cases. These results show that p57DV are a diagnostic challenge for pathologists and that most are associated with a CHM component. However, the clinical management of p57DV-associated CHMs should be the same as that of classic CHMs.
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Affiliation(s)
- Lucie Gaillot-Durand
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Sophie Patrier
- Department of Pathology, Rouen University Hospital, Rouen, 76100, France
| | - Jacqueline Aziza
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, University Cancer Institute Toulouse Oncopole, MD Toulouse, 31059, France
| | - Louise Devisme
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Lille University Hospital, Lille, 59000, France
| | - Anne-Claude Riera
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Medipath, Eguilles, 13510, France
| | - Pascale Marcorelles
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Brest University Hospital, Brest, 29200, France
| | - Fanny Pelluard
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Bordeaux University Hospital, Bordeaux, 33000, France
| | - Bernard Gasser
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Pathology, Mulhouse Hospital, Mulhouse, 68200, France
| | - Claire Mauduit
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France
| | - Touria Hajri
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Jérôme Massardier
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Femme-Mère-Enfants University Hospital, Hospices Civils de Lyon, Bron, 69500, France
| | - Pierre-Adrien Bolze
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - François Golfier
- French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France; Department of Gynecology and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Mojgan Devouassoux-Shisheboran
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France
| | - Fabienne Allias
- Department of Pathology, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, 69495, France; French Reference Center for Gestational Trophoblastic Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 69495, France.
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Ha TK, Mardy AH, Beleford D, Spanier A, Wayman BV, Penon-Portmann M, Wiita AP, Shieh JT. X-linked duplication copy number variation in a familial overgrowth condition. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:644-649. [PMID: 31762227 DOI: 10.1002/ajmg.c.31756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 01/16/2023]
Abstract
We describe an overgrowth condition associated with X-linked copy number variation. Three brothers displayed an overgrowth pattern at birth that continued postnatally. Clinical findings included macrocephaly, distinctive facial features, developmental delay and variable clubfoot. Normal fetal growth was noted until the third trimester by Hadlock standards, revealing a late gestational overgrowth pattern. Microarray analysis in the family showed a maternally inherited 680 kb copy number duplication at Xq26.1-q26.2 in all three brothers. Molecular sequencing for known overgrowth conditions including GPC3, Sotos 1 (NSD1), Malan (NFIX), Perlman (DIS3L2), Weaver (EZH2), Opitz-Kaveggia (MED12) loci were negative. BWS IC1 and IC2 methylation and CDKN1C testing was also negative. Normal IGF1 levels excluded X-linked acrogiantism. The duplicated region Xq26.1-q26.2 contained IGSF1 and at least part of the lncRNA FIRRE. IGSF1, a highly expressed pituitary immunoglobulin superfamily gene, was recently implicated in a genome-wide association study of canine size. IGSF1 variants were associated with large canine breeds compared to smaller breeds. Our findings support the hypothesis that an X-linked variant encompassing the IGSF1 region may be associated with body size. Although IGSF1 loss has been noted in human hypothyroidism, this is the first reported phenotype in a family with copy number duplication in the region. Our findings suggest that prenatal evaluation, cross-species evaluation, Mendelian, and GWAS studies may describe a distinctive familial condition and its corresponding phenotypic features.
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Affiliation(s)
- Thoa K Ha
- Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, California
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Anne H Mardy
- Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, California
- Alameda Health System, Eastmont Wellness Center, Oakland, California
| | - Daniah Beleford
- Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Andrew Spanier
- Alameda Health System, Eastmont Wellness Center, Oakland, California
| | - Brette V Wayman
- UCSF Health Center for Clinical Genetics and Genomics, University of California San Francisco, San Francisco, California
| | - Monica Penon-Portmann
- Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Arun P Wiita
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Joseph T Shieh
- Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, California
- Institute for Human Genetics, University of California San Francisco, San Francisco, California
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Maternal GRB10 microdeletion is a novel cause of cystic placenta: Spectrum of genomic changes in the etiology of enlarged cystic placenta. Placenta 2017; 57:33-41. [DOI: 10.1016/j.placenta.2017.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 01/30/2023]
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Sunde L, Lund H, J Sebire N, Grove A, Fisher RA, Niemann I, Kjeldsen E, Andreasen L, Hansen ES, Bojesen A, Bolund L, Nyegaard M. Paternal Hemizygosity in 11p15 in Mole-like Conceptuses: Two Case Reports. Medicine (Baltimore) 2015; 94:e1776. [PMID: 26554776 PMCID: PMC4915877 DOI: 10.1097/md.0000000000001776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hydatidiform mole is an abnormal human pregnancy characterized by the fetus being absent or nonviable, and the chorionic villi being vesicular and with trophoblastic hyperplasia. Most often, the mole phenotype is seen in conceptuses with an excess of paternally inherited genome set(s) relative to maternally inherited genome set(s), suggesting that the phenotype is caused by an excess of genome with a paternal imprinting pattern. However, it is unknown if correct parental origin of every imprinted gene is crucial for normal early differentiation or if abnormal parental imprinting of only one, or some, gene(s) can cause the mole phenotype.Two conceptuses included in the Danish Mole Project stood out since they presented with vesicular chorionic villi and without signs of fetal differentiation, and had apparently biparental diploid genomes, and no mutations in NLRP7 or KHDC3L were detected in the mothers. These conceptuses were subjected to a centralized histopathological revision and their genetic complements were scrutinized using fluorescence in situ hybridization, and DNA-marker and array comparative genomic hybridization analyses. Both conceptuses showed dysmorphic chorionic villi with some similarities to hydatidiform moles; however, no definite florid trophoblast hyperplasia was observed. Both conceptuses showed paternal hemizygosity of 11pter-11p15.4, most likely in nonmosaic state.Our findings suggest that the product of one (or a few) maternally expressed gene(s) on the tip of chromosome 11 is necessary for normal early embryonic differentiation. However, since the present two cases did not exhibit all features of hydatidiform moles, it is likely that abnormal parental imprinting of genes in other regions contribute to the phenotype of a hydatidiform mole.
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Affiliation(s)
- Lone Sunde
- From the Department of Clinical Genetics, Aarhus University Hospital, Aarhus N, Denmark (LS); Institute of Pathology, Aalborg University Hospital, Aalborg, Denmark (HL, AG); Trophoblastic Tumour Screening and Treatment Centre, Department of Oncology, Imperial College Healthcare NHS (NJS, RF); Institute of Child Health, University College London (NJS); Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College London, London, UK (RF); Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus N (IN); Hemodiagnostic Laboratory, CancercytogeneticSection, Aarhus University Hospital, Aarhus C, Denmark (EK); Department of Immunology and Biochemistry, Vejle Sygehus, Vejle, Denmark (LA); Department of Pathology, Aarhus University Hospital, Aarhus C, Denmark (EH); Department of Clinical Genetics, Vejle Sygehus, Vejle, Denmark (AB); Department of Biomedicine, Aarhus University, Aarhus C, Denmark (LS, LB, MN); and Beijing Genomics Institute/HuaDa-Shenzhen, Shenzhen, China (LB)
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Ishikawa S, Morikawa M, Yamada T, Akaishi R, Kaneuchi M, Minakami H. Prospective risk of stillbirth in women with placental mesenchymal dysplasia. J Obstet Gynaecol Res 2015; 41:1562-8. [DOI: 10.1111/jog.12757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 03/25/2015] [Accepted: 04/15/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Satoshi Ishikawa
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Mamoru Morikawa
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Takahiro Yamada
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Rina Akaishi
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Masanori Kaneuchi
- Department of Obstetrics and Gynecology; Nagasaki University Graduate School of Medicine; Nagasaki Japan
| | - Hisanori Minakami
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Japan
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Chen CP, Ko TM, Chen CY, Wang TY, Chern SR, Kuo YL, Wang W. First-trimester molecular diagnosis of complete hydatidiform mole associated with dizygotic twin pregnancy conceived by intrauterine insemination. Taiwan J Obstet Gynecol 2014; 53:572-8. [PMID: 25510703 DOI: 10.1016/j.tjog.2014.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To present first-trimester molecular diagnosis of complete hydatidiform mole (CHM) associated with dizygotic twin pregnancy conceived by intrauterine insemination. MATERIALS AND METHODS A 32-year-old woman presented to the hospital with a huge complex cystic mass measuring about 8.5 cm × 4.1 cm in the uterine cavity and a living co-existing fetus with fetal biometry equivalent to 9 weeks. She underwent chorionic villus sampling at 13 weeks of gestation, and microsatellite genotyping for molar pregnancy test was applied. A molar pregnancy test was performed by a short tandem repeat (STR) identifier polymerase chain reaction (PCR) polymorphic marker analysis. The pregnancy was terminated at 14 weeks of gestation. Postnatal polymorphic DNA marker analysis of the placenta by quantitative fluorescent PCR (QF-PCR) was performed. Analysis of maternal blood total β-human chorionic gonadotropin revealed a high level of 551,600 mIU/mL at 10 weeks of gestation and a level of 1.0 mIU/mL at 15 weeks postpartum. The woman was doing well at 4 months after delivery. RESULTS The results of STR identifier PCR polymorphic marker analysis showed androgenic conception in the complex cystic mass and biparental conception in the living fetus. Pathological analysis of the cystic mass confirmed the diagnosis of CHM. The results of QF-PCR showed biparental inheritance in the normal fetus and complete paternal homozygosity in the CHM of the abnormal fetus in all STRs, indicating dizygotic twinning and CHM of monospermy. CONCLUSION Prenatal sonographic diagnosis of placentomegaly with many grape-like vesicles should include a differential diagnosis of CHM, partial hydatidiform mole (PHM), placental mesenchymal dysplasia (PMD), and recurrent hydatidiform mole. Microsatellite genotyping for molar pregnancy testing and zygosity testing is useful in cases of prenatal diagnosis of placentomegaly associated with many grape-like vesicles and a twin pregnancy with a living fetus in the first trimester.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Tsang-Ming Ko
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei, Taiwan
| | - Chen-Yu Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Tao-Yeuan Wang
- Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Ling Kuo
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wayseen Wang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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Abstract
Placental mesenchymal dysplasia is a rare placental lesion characterized by stem villous cystic dilation and vesicle formation, placentomegaly, and vascular abnormalities. It can be associated with growth restriction, stillbirth, Beckwith-Wiedemann syndrome, and some chromosomal abnormalities, and needs to be distinguished from its main differential diagnosis, hydatidiform mole.
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Affiliation(s)
- Nogba Pawoo
- From the Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey
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Chen CP, Su YN, Lin MH, Wang TY, Chern SR, Kuo YL, Chen YT, Wang W. Detection of altered methylation status at 11p15.5 and 7q32 in placental mesenchymal dysplasia. Taiwan J Obstet Gynecol 2014; 53:68-73. [DOI: 10.1016/j.tjog.2013.10.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/30/2022] Open
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Chen CP, Hsu CY, Su YN, Wang TY, Chern SR, Su JW, Wang W. Placental mesenchymal dysplasia associated with antepartum hemorrhage, subchorionic hematoma, and intrauterine growth restriction. Taiwan J Obstet Gynecol 2013; 52:154-6. [PMID: 23548244 DOI: 10.1016/j.tjog.2013.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Chih-Ping Chen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
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Abstract
Placental mesenchymal dysplasia is a rare, incompletely understood placental stromal lesion, characterized by placentomegaly and striking ectasia and tortuosity of chorionic plate and stem villous vessels. Its prenatal ultrasonographic and gross pathologic features resemble those of a partial mole, but the fetus is typically normal and the placenta has a diploid, chromosomal complement. We discuss the pathologic features and current understanding of the etiopathogenesis of this condition, the supportive immunohistochemical and confirmatory molecular genetic studies important in its diagnosis, and its implications for pregnancy and infant outcomes.
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Affiliation(s)
- Ona Marie Faye-Petersen
- Pathology, The University of Alabama at Birmingham, 619 19th Street South, NP 3547, Birmingham, AL 35249-7331, USA; Obstetrics and Gynecology, The University of Alabama at Birmingham, 619 19th Street South, NP 3547, Birmingham, AL 35249-7331, USA.
| | - Raj P Kapur
- Department of Laboratories, The University of Washington, Seattle Children's Hospital & Regional Medical Center, A6901, 4800 Sand Point Way, NE, Seattle, WA 98105, USA
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Ohira S, Ookubo N, Tanaka K, Takatsu A, Kobara H, Kikuchi N, Ohya A, Kanai M, Shiozawa T. Placental Mesenchymal Dysplasia: Chronological Observation of Placental Images during Gestation and Review of the Literature. Gynecol Obstet Invest 2013; 75:217-23. [DOI: 10.1159/000350661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 03/12/2013] [Indexed: 11/19/2022]
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Lloreda-García JM, Castellanos JLL, Sánchez JS. A preterm infant with anaemia and left leg mild hemihypertrophy (discussion and diagnosis). Acta Paediatr 2012; 101:1270-1. [PMID: 23134436 DOI: 10.1111/j.1651-2227.2012.02817.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bourque DK, Peñaherrera MS, Yuen RKC, Van Allen MI, McFadden DE, Robinson WP. The utility of quantitative methylation assays at imprinted genes for the diagnosis of fetal and placental disorders. Clin Genet 2011; 79:169-75. [DOI: 10.1111/j.1399-0004.2010.01443.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Eggermann T, Spengler S, Bachmann N, Baudis M, Mau-Holzmann UA, Singer S, Rossier E. Chromosome 11p15 duplication in Silver-Russell syndrome due to a maternally inherited translocation t(11;15). Am J Med Genet A 2010; 152A:1484-7. [PMID: 20503324 DOI: 10.1002/ajmg.a.33398] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The role of 11p15 disturbances in the aetiology of Silver-Russell syndrome (SRS) is well established: in addition to hypomethylation of the H19/IGF2 differentially methylated regions, five patients with a duplication of maternal 11p15 material have been described. We report on a boy with SRS carrying a maternally inherited duplication of chromosome 11p15. The patient showed the typical clinical picture of SRS including severe intrauterine and postnatal growth restriction, relative macrocephaly, a prominent forehead, a triangular face, down-turned corners of the mouth and fifth digit clinodactyly. Body asymmetry was not observed. By molecular genetic analyses, MLPA and microsatellite typing detected a duplication of chromosome 11p15 and cytogenetic analysis showed an unbalanced translocation t(11;15)(p15.5:p12). The size of the duplicated region is approximately 8.8 Mb as determined by SNP-array analysis. The healthy mother carried a balanced reciprocal chromosome translocation t(11;15). Thus, there is an increased risk for further children with SRS due to 11p15 duplication. Additionally, the family is at risk for offspring with an 11p15 deletion and Beckwith-Wiedemann syndrome whereby the phenotype will be influenced by haploinsufficiency of additional genes at 11p15 due to the deletion. The balanced aberrant karyotype was identified in several other family members, but interestingly there was no history of recurrent miscarriages, intrauterine fetal death, or multiple congenital anomaly syndromes in the family.
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Vaisbuch E, Romero R, Kusanovic JP, Erez O, Mazaki-Tovi S, Gotsch F, Kim CJ, Kim JS, Yeo L, Hassan SS. Three-dimensional sonography of placental mesenchymal dysplasia and its differential diagnosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2009; 28:359-368. [PMID: 19244073 PMCID: PMC2713740 DOI: 10.7863/jum.2009.28.3.359] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Placental mesenchymal dysplasia (PMD) is an uncommon vascular anomaly of the placenta characterized by mesenchymal stem villous hyperplasia. Its main sonographic feature is a thickened placenta with hypoechoic areas, and an accurate sonographic diagnosis is challenging. The aim of this study was to report 2 cases of PMD and discuss the differential diagnosis of its sonographic features. METHODS Cases of placental masses were studied by 2-dimensional (2D), 3-dimensional (3D), and color Doppler imaging. RESULTS In case 1, a thick placenta with multiple hypoechoic areas was noted at 13 weeks' gestation. At 19 weeks, the multicystic area, clearly demarcated from a normal-looking placenta, measured 6.5 x 8.5 cm and enlarged gradually. The patient gave birth to a 625-g female neonate after spontaneous labor at almost 26 weeks' gestation. In case 2, a first sonographic examination at 25 weeks' gestation revealed a thickened placenta with hypoechoic areas and a fetus with a single umbilical artery and a ventricular septal defect. At 27 weeks, the abnormal area of the placenta measured 14.5 x 7.5 cm. At 32 weeks' gestation, a caesarean delivery was performed because of a nonreassuring fetal heart tracing, and a 1415-g female neonate was delivered. Both cases were evaluated by 2D, 3D, and color Doppler imaging, and the pathologic features of both placentas were consistent with PMD. CONCLUSIONS Placental mesenchymal dysplasia should be considered in the differential diagnosis of every placental mass, especially in cases of multicystic placental lesion with lack of high-velocity signals inside the lesion, and a normal karyotype.
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Affiliation(s)
- Edi Vaisbuch
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, USA
| | - Juan Pedro Kusanovic
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Offer Erez
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Shali Mazaki-Tovi
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Francesca Gotsch
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
| | - Chong Jai Kim
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jung-Sun Kim
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Lami Yeo
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sonia S. Hassan
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Allias F, Lebreton F, Collardeau-Frachon S, Azziza J, Pasquier CJ, Arcin-Thoury F, Patrier S, Devouassoux-Shisheboran M, Patrier S. Immunohistochemical expression of p57 in placental vascular proliferative disorders of preterm and term placentas. Fetal Pediatr Pathol 2009; 28:9-23. [PMID: 19116812 DOI: 10.1080/15513810802545350] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
P57 protein is implicated in some human imprinting disorders such as hydatiform mole and Beckwith-Wiedemann syndrome (BWS), both characterized by mesenchymal and vascular placental abnormalities. We investigated p57 immunohistochemical expression in placental vascular proliferative disorders of preterm and term placentas, including chorangiosis (n = 5), chorangiomatosis (n = 2), chorangiomas (n = 7), umbilical cord angioma (n = 1), and placental mesenchymal dysplasia (PMD) (n = 7). P57 was expressed in decidua, cytotrophoblast, intermediate trophoblast and stromal cells of normal terminal, intermediate and stem villi, umbilical cord, chorangiosis, chorangiomatosis, and chorangiomas. In contrast, there was a loss of p57 expression in stromal cells of dysplastic stem villi in all cases of PMD regardless of whether associated with BWS or not. P57 seems to be involved in the pathogenesis of a subset of placental vascular proliferative disorders in preterm and term placentas, such as PMD. The loss of p57 expression in PMD could be of diagnostic value in helping to distinguish this rare placental lesion from its mimickers.
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Affiliation(s)
- Fabienne Allias
- Service d'Anatomie et Cytologie Pathologiques, Hopital de la Croix-Rousse, Lyon, France.
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Kagami M, Yamazawa K, Matsubara K, Matsuo N, Ogata T. Placentomegaly in paternal uniparental disomy for human chromosome 14. Placenta 2008; 29:760-1. [PMID: 18619672 DOI: 10.1016/j.placenta.2008.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 06/03/2008] [Accepted: 06/04/2008] [Indexed: 12/27/2022]
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Molecular and clinical findings and their correlations in Silver-Russell syndrome: implications for a positive role of IGF2 in growth determination and differential imprinting regulation of the IGF2–H19 domain in bodies and placentas. J Mol Med (Berl) 2008; 86:1171-81. [DOI: 10.1007/s00109-008-0377-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 05/08/2008] [Accepted: 05/30/2008] [Indexed: 01/15/2023]
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Yamazawa K, Kagami M, Ogawa M, Horikawa R, Ogata T. Placental hypoplasia in maternal uniparental disomy for chromosome 7. Am J Med Genet A 2008; 146A:514-6. [DOI: 10.1002/ajmg.a.32125] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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