PLACENTAL PATHOLOGY IN MATERNAL AND NEONATAL MYELOPROLIFERATIVE DISORDERS
PLACENTAL PATHOLOGY IN MATERNAL AND NEONATAL MYELOPROLIFERATIVE DISORDERS
复制标题
孕产妇和新生儿骨髓增生性疾病的胎盘病理学
DOI：
10.1016/s0029-7844(98)00023-4
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发表时间：
1998
影响因子：
7.2
通讯作者：
Amy P. Fantaskey
中科院分区：
文献类型：
--
作者：
S. Lentz;Carol C. Coulson;C. Gocke;Amy P. Fantaskey
电视是一名31岁的经产妇，在怀孕期间出现持续3个月的左侧腹股沟肿块。先前的手术探查发现了一例与粒细胞肉瘤相一致的未成熟恶性肿瘤。妊娠进展到34周，在此期间，患者继续与开放的、坏死的和恶性浸润性腹股沟伤口作斗争。一名健康的婴儿在34周时经阴道分娩。产前，腹股沟肿块切除至腹股沟深管水平。标本显示为血淋巴恶性，基因重排和单抗分型与真正的组织细胞性淋巴瘤一致。完成分期的计算机断层扫描显示胸部无活动性病变，中度腹主动脉周围淋巴结病，左侧腹股沟持续肿块10 6 7cm3。手术后，患者出现严重的脓毒症，并伴有大面积的肺栓塞，最终死亡。尸检显示广泛播散性组织细胞淋巴瘤。KR是一名35岁的Secundagravida，因不断恶化的胎儿积水而入院。32周时超声检查显示羊水过多，大量心包积液，中线囊性中枢神经系统扩张，肝脾肿大。胎儿超声心动图显示法洛四联症。尽管经过了长时间的住院和评估，但胎儿状况的病因仍不清楚。因胎儿宫内窘迫在35周时进行剖宫产。表型与21三体一致。脐带血血气在正常范围内。最初的新生儿白细胞计数为224,000，外周涂片显示为急性髓系白血病，有巨核细胞和红系标志。在没有化疗的情况下，白细胞计数降到了正常水平。核型分析证实为唐氏综合征。
TV is a 31-year-old multipara who presented with a left groin mass of 3 months’ duration concurrent with pregnancy. Prior surgical exploration had identified an immature malignancy consistent with a granulocytic sarcoma. Pregnancy progressed to 34 weeks, during which the patient continued to struggle with an open, necrotic, and malignantly infiltrated groin wound. Vaginal delivery of a healthy infant occurred at 34 weeks. Antepartum, excision of the groin mass to the level of the deep inguinal canal was accomplished. The specimen showed a hematolymphoid malignancy with gene rearrangement and monoclonal antibody typing consistent with a true histiocytic lymphoma. Computed tomography scan to complete staging indicated no active disease in the chest, moderate periaortic lympadenopathy, and a persistent 10 6 7 cm3 left inguinal mass. Postoperatively, the patient developed overwhelming sepsis along with a massive pulmonary embolism and died. Postmortem examination showed widely disseminated histiocytic lymphoma. KR is a 35-year-old secundagravida who was admitted for worsening fetal hydrops. An ultrasound obtained at 32 weeks demonstrated polyhydramnios, a large pericardial effusion, midline cystic dilation of the central nervous system, and hepatosplenomegaly. Fetal echocardiography showed tetralogy of Fallot. Despite a prolonged hospitalization and evaluation, the etiology of the fetal condition remained unclear. A cesarean delivery was performed at 35 weeks for fetal distress. Phenotype was consistent with trisomy 21. Cord blood gases were within the normal range. The initial neonatal leukocyte count was 224,000 with a peripheral smear showing an acute myeloid leukemia with megakaryocytic and erythroid markers. The leukocytosis resolved to a normal level without chemotherapy. Karyotype confirmed Down syndrome.