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Original Articles
- Cystic Hygroma of the Neck Pathologic study of 26 autopsy cases.
- Yeon Lim Suh, Je Geun Chi
- Korean J Pathol. 1997;31(12):1256-1263.
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Abstract
PDF - Cystic hygroma is a congenital malformation of the lymphatic system appearing single or multiloculated fluid-filled cavities, most often around the neck. They often progress to hydrops and cause fetal death, and frequently associated with chromosomal abnormalities and other congenital malformations. The purpose of our study is to delineate the nature of cystic hygroma and determine the relationship between cystic hygroma and associated anomalies including fetal hydrops. We used data from 26 cases of cervical cystic hygroma in autopsy files of SNU Children's Hospital. Most of cystic hygroma were found in stillborn or premature infants. The fetal cases had been dead for a quite a long period since there was discrepancy between the true gestational age and the developmental age estimated from the body length. Of 26 fetuses only 2 were studied chromosomally and both of them showed 45X. Of 26 cystic hygromas 23 occurred in the posterior neck and 3 in the anterior neck. They ranged from 2.5 to 14 cm (mean: 7.9 cm). The cystic hygroma of the posterior neck consisted of two symmetric sacs on both sides and in the nape and extended to the occipital region. The cystic hygromas of the anterior neck were unilateral or bilateral, and multiloculated and extended into the adjacent cheek. Cystic hygromas of posterior neck were always associated with hydrops, while no recognizable hydrops was found in cystic hygromas of anterior neck. The cystic hygromas were larger in patients with severe hydrops than in patients with less severe hydrops. Associated abnormalities, found in 88%, included hydrops fetalis(88%), growth retardation(80%), cardiovascular anomalies(27%), horseshoe kidney(23%), skeletal anomalies(12%) and hypoxic changes(31%) in visceral organs. In summary, when a hygroma is detected during fetal life, careful sonographic examination for associated congenital anomalies, fetal karyotyping and consideration of artificial abortion are indicated.
- Causes of Hydrops Fetalis: Analysis of 149 Autopsy Cases.
- Ho chang Lee, Je G Chi, Sung Hye Park
- Korean J Pathol. 2007;41(2):103-108.
- 2,296 View
- 81 Download
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Abstract
PDF
- BACKGROUND
Hydrops fetalis is defined as abnormal accumulation of serous fluid in two or more fetal compartments, and this malady is known to be associated with various pathologic conditions.
METHODS
We collected 149 cases of hydrops fetalis out of 2,312 autopsies, and we tried to elaborate the underlying causes of hydrops fetalis. The diagnosis was based on the material from either antenatal termination or intrauterine death.
RESULTS
The relative incidence of hydrops fetalis was 6.44% of all the pediatric autopsies we performed. The gestational age was evenly distributed from 18 to 33 weeks, except for 30 to 31 weeks. There was no sex difference in the incidence of hydrops fetalis. The main causes were cardiovascular diseases (30.9%), cystic hygroma (13.4%), chromosomal anomaly (8.05%), thoracic conditions (7.38%), followed by urinary tract malformation (4.03%), infection (4.03%) and anemia (3.36%). The most common chromosomal anomaly was Turner syndrome and the second one was Down syndrome.
CONCLUSION
Since various conditions can be the cause of hydrops fetalis, pathologists should pay attention to elaborate the underlying causes in every single autopsy.
Case Reports
- Hydrops Fetalis Due to Parvovirus B19 Infection: Report of Two Autopsy Cases.
- Ho Chang Lee, Hee Eun Lee, Pil Gyu Hwang, Je G Chi, Sung Hye Park
- Korean J Pathol. 2006;40(3):245-249.
- 1,771 View
- 27 Download
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Abstract
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- Hydrops fetalis (HF) is a disease characterized by generalized subcutaneous edema and cavity effusion in the fetal stage. We report here on two autopsy cases of HF that were caused by parvovirus B19 (PVB19) infection. The human PVB19 is an erythrovirus that cause diverse clinical manifestations ranging from an asymptomatic or mild presentation to more severe effects such as hydrops fetalis, and this is the only known human pathogenic parvovirus. The gestational ages of the two fetuses were 21 weeks and 23 weeks, respectively. Both fetuses were hydropic and anemic. Hepatic tissues of both fetuses demonstrated erythroblasts with eosinophilic intranuclear inclusions, the so called "lantern cells". PVB19 was confirmed by electron microscopy and immunohistochemical staining. For the diagnosis of this disease, recognition of parvovirus infection as a cause of hydrops fetalis and careful examination of red blood cells with a high-power view are required.
- Congenital Omental Cyst Associated with Hydrops Fetalis: An autopsy case.
- Mi Kyung Kim, Je G Chi
- Korean J Pathol. 1989;23(1):160-164.
- 1,693 View
- 14 Download
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Abstract
PDF
- Omental cyst is benign unilocular or multilocular endothelium-lined cyst that contains either chyle or serous fluid. They are uncommon yet interesting intraabdominal masses that may be difficult to diagnose clinically and often are missed on abdominal palpation. The etiology of this lesion has been subject to much discussion in the literature over the years with the principal debate centering around the question of whether or not this lesion is congenital. It is now recongnized that there is no single etiologic mechanism involved in the development of this lesion. Recently we have experienced an autopsy case of omental cyst occurring in a male fetus. Pregnancy was artificially interrupted at 28 weeks gestation due to suspicious mesenteric cyst or fetal ascites on ultrasonography. Postmortem examination showed hydrops fetalis, hypoplasia of the lungs, ad multifocal calcifications of myocardium. There was an omental cyst in the greater omentum which was 7x3 cm in size, unilocular and containing clear, straw-colored fluid and proteinacious core without evidence of bleeding or calcifications. Microscopic examination of this cyst showed cuboidal or flattened mesothelial lining cells and underlying loose fibrovascular connective tissue with discrete lymphocytic collections. Rarity and interest on the pathogenesis made us redport this case.
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