Professional Documents
Culture Documents
ATLAS Pediatric-Perinatal Pathology
ATLAS Pediatric-Perinatal Pathology
Tutorials
Malformations and Deformations:
1. Cleft lip, gross
2. Lateral cleft lip, gross
3. Facial abnormalities, gross
4. Hands with abnormal crease, gross
5. Omphalocele, gross
6. Gastroschisis, gross
7. Limb-body wall complex, gross
8. Limb-body wall complex, gross
9. Alobar holoprosencephaly, gross
10. Semilobar holoprosencephaly, gross
11. Holoprosencephaly, gross
12. Hydranencephaly, gross
13. Syndactyly, hand and foot, gross
14. Syndactyly, hand, gross
15. Bowel atresia, gross
16. Duodenal atresia, gross
17. Colonic atresia, gross
18. Tracheo-esophageal fistula and atresia, gross
19. Sirenomelia, gross
20. Intrauterine fetal demise, external features, gross
21. Recessive polycystic kidney disease, gross
22. Diaphragmatic hernia, gross
23. Diaphragmatic hernia, gross
24. Renal agenesis, gross
25. 'Potter facies' from oligohydramnios, gross
26. 'Potter facies' and 'glove-like' hand from oligohydramnios, gross
microscopic
Intraventricular hemorrhage, gross
Intraventricular hemorrhage, severe, gross
Kernicterus, brain, gross
Neonatal necrotizing enterocolitis (NEC), gross
Neonatal necrotizing enterocolitis (NEC) and normal bowel, low
power microscopic
Miscellaneous Conditions:
This is large lateral abdominal wall defect does not involve the umbilical
cord and is not covered by a membrane. This is a gastroschisis. Much
of the bowel, stomach, and liver are herniated outside the abdominal
cavity.
The two enormous masses beneath the liver are cystic kidneys.
This is an example of autosomal recessive polycystic kidney disease
(ARPKD).
A diaphragmatic hernia on the left allows herniation of bowel into the left
chest cavity. The herniating liver has become tilted vertically. Incursion
of abdominal contents into the chest cavity will result in pulmonary
hypoplasia. Though diaphragmatic hernia may occur as an isolated
defect that is potentially repairable, most are associated with multiple
anomalies, and often with chromosomal abnormalities.
Neural tube defects are are one of the more common congenital
anomalies to occur. Such defects result from improper embryonic
neural tube closure. The most minimal defect is called spina bifida, with
failure of the vertebral body to completely form, but the defect is not
open. Open neural tube defects with lack of a skin covering, can include
a meningocele, in which meninges protrude through the defect. Here is
a large meningomyelocele in which the defect is large enough to allow
meninges and a portion of spinal cord to protrude through the defect.
Such defects can be suggested by an elevated maternal serum alphafetoprotein (MSAFP).
Note the absence of the cranial vault in this fetus with anencephaly.
Supplementing the maternal diet with folate prior to and during
pregnancy can reduce the incidence of neural tube defects.
There is a large mass involving the left upper arm and left chest of
this fetus. This congenital neoplasm turned out to be a
lymphangioma.
Beneath the skin surface at the left are many dilated vascular
channels filled with many red blood cells. This is a neoplasm known
as a hemangioma.
The large pink inclusion in the erythroid precursor seen here in fetal
spleen is evidence for parvovirus infection. Parvovirus, or "fifth"
disease, produces a mild illness in children, marked by a "slapped
cheek" facial rash. In adults, the illness often goes unnoticed, but
pregnant women can pass the virus to the fetus, where it may
produce marked fetal anemia and hydrops in some cases.
The dense layer of small dark blue cells seen here below the
ependyma of the lateral ventricle is the germinal matrix. The
germinal matrix is a highly cellular and highly vascularized region
from which cells migrate out during brain development, mainly
between 22 and 30 weeks gestation. This area is highly vulnerable
to birth injury and changes in blood pressure following birth. If
severe and if survival occurs, the hemorrhage may organize and
lead to obstructive hydrocephalus. A germinal matrix hemorrhage
is shown below.
Meconium ileus is most often seen in the first few days of life in
neonates with cystic fibrosis, but can rarely occur in infants with a
normal pancreas. In cystic fibrosis, the abnormal pancreatic
secretions lead to inspissated meconium that produces intestinal
obstruction. The dilated coils of ileum are opened here to reveal the
inspissated green meconium (which may also be tarry or gritty),
while the unopened colon at the upper left and the appendix at the
lower left beyond the ileocecal valve are not dilated, and little or no
meconium is passed per rectum. [Image contributed by Ted Pysher,
MD, University of Utah]
The skin is soft and the hair is fine in a normal newborn, as seen
here.
The normal fetal chest at term is shown here. The thymus is a large
structure with the important job of developing the cell-mediated
immune system with T-cells. The right lung, heart, diaphragm, and
liver are seen here as well.