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Biomedical subjects

M Mostoufi-Zadeh

Publications and source records attributed to M Mostoufi-Zadeh.

6 recordsLinked to original sources

Persistence of partial mole.

Between January 1979 and August 1984, 8 of 81 patients with partial molar pregnancy who were followed at the New England Trophoblastic Disease Center had persistent trophoblastic tumor develop. No significant clinical differences were noted between such patients and others whose partial moles did not persist. On microscopic examination, none of the initial molar specimens manifested an unusual degree of trophoblastic proliferation or atypia. In six patients, curettage immediately preceding the initiation of treatment for persistent disease revealed viable molar tissue. In four, this was associated with trophoblastic hyperplasia and atypia. All patients who had persistent gestational trophoblastic tumor achieved remission with single-agent chemotherapy. Monitoring of serum human chorionic gonadotropin levels after partial molar pregnancy is recommended to detect persistent disease and effect prompt therapy.

Adult

Invasive partial mole.

A case of invasive partial hydatidiform mole requiring chemotherapy and hysterectomy in a 30-year-old white woman is presented. This is the first histologically and cytogenetically documented partial mole with persistent elevation of human chorionic gonadotropin (hCG) level and invasion of myometrium. There was no evidence of distant spread.

Adult

Implantation site in complete molar pregnancy: a study of immunologically competent cells with monoclonal antibodies.

The nature and intensity of inflammatory cellular infiltrate in the implantation sites of 10 complete molar pregnancies were evaluated by immunohistochemical staining of frozen tissue sections with monoclonal antibodies. As compared to the implantation site in normal pregnancy, there was an increase in the number of infiltrating inflammatory cells in the molar implantation site. Most of the inflammatory cells were T cells with predominance of T4+ (Leu-3a+) cells over T8+ cells. Inflammatory cells were not detected in the molar vesicles. The possible implications of these findings in molar pregnancy are discussed.

Antibodies, Monoclonal

Nonimmune hydrops fetalis: a challenge in perinatal pathology.

Autopsies were performed in 40 cases of nonimmune hydrops fetalis during the period from 1975 to 1983. In 25 cases specific anatomic diagnoses, including hematologic disorders, infections, chromosomal abnormalities, congenital anomalies, and tumors, were made. In the majority the diagnosis of hydrops fetalis was made prenatally by ultrasonography. The mean gestational age at delivery was 30 weeks; 23 infants were stillborn, and 17 died during the neonatal period. Body weights were consistently increased; peripheral edema and ascites were present in all cases and pleural effusions in all but two cases. Hepatosplenomegaly, cardiomegaly, and pulmonary hypoplasia were frequent findings. The most consistent microscopic changes involved endocrine organs. Islet cell hyperplasia and Leydig cell hyperplasia were common, and thyroid hyperplasia was found occasionally. The fetal zone of the adrenal cortex was often thick and composed of swollen, vacuolated cells. Enhanced extramedullary erythropoiesis was observed in all cases. Thirty-nine placentas were examined; 34 were edematous (mean weight, 547 g), with villous edema, excess erythroblastemia and normoblastemia, and occasional intravillous hematopoiesis. Nonimmune hydrops fetalis has a range of known causes. Thorough autopsy, including placental examination, is the most useful approach for determining the etiology. In 23 cases the probable or possible cause was established in this manner. Antibody studies should also be performed in all cases to exclude an immunologic etiology. Synthesis of clinical, serologic, and pathologic data offers prospects for rational management and prediction of recurrence.

Autopsy

Implantation site in normal pregnancy. A study with monoclonal antibodies.

In the present study, the presence of major histocompatibility complex antigens (MHC) and the degree and nature of inflammatory response in the human placenta were determined by staining frozen tissue sections with monoclonal antibodies and an immunoperoxidase technique. Although class I (HLA-A, B, and C) and Class II (HLA-DR, Ia-like) MHC antigens were not demonstrated in the syncytiotrophoblast, Class I antigens were found in trophoblast of the placental septum, shell, and implantation site and in the chorionic villous stroma. There was no staining for Ia-like antigens in the fetal components of the placenta. T cells were scarce and evenly scattered in the normal implantation site. No T cells infiltrated the chorionic villi. B cells and natural killer cells were not identified in the human placenta. Macrophages constituted more than 20% of the decidual cells and had morphologic features identical to those of "small decidual cells." The lack of T-cell infiltration of the fetal placental structures and their scarcity in the implantation site support the notion that T-cell-mediated immune response against placental antigens is not generated by the maternal host in normal pregnancy. The abundance of macrophages at the implantation site may be related to their possible role in the suppression of immune response.

Antibodies, Monoclonal