Objective:To investigate the clinicopathological and genetic features of confined placental mosaicism (CPM) and its effect on fetal intrauterine growth.Methods:Fourteen CPM cases of Haidian Maternal and Children Health Hospital were collected from May 2018 to March 2022. Clinicopathological examination on placental specimens and molecular genetic analysis were performed.Results:The age of the parturient women ranged from 27 to 34 years, with an average age of (30.0±3.54) years. The gestational weeks ranged from 35 +1 to 41 +2 weeks. There were 4 premature births and 10 term births, among which 6 were female and 8 were male fetuses. Nine cases (9/14) had adverse pregnancy outcomes, including 7 cases of fetal growth restriction. The weight of CPM placenta decreased, with 6 cases below the 10th percentile of weight standards and 5 cases between the 10th and 25th percentile. All 14 CPM placental specimens showed morphological changes of perfusion dysfunction to varying degrees, with mainly placental-maternal vascular malperfusion followed by placental-fetal vascular malperfusion. The mosaic chromosomes in different CPM cases varied, with 16-trisomy/monosomy mosaicism being the most common followed by 7-trisomy and 21-trisomy/monosomy mosaicism. The mosaic proportion was unequal in different parts of the same CPM placenta, with the mosaic proportion of umbilical cord, fetal membranes, fetal surface, maternal surface, and edge ranging from 1% to 70%. Conclusions:The mosaic chromosomes in different CPM cases vary, and the mosaic proportion is unequal in different parts of the same CPM placenta. The pathological morphology is mainly manifested as perfusion dysfunction, which can lead to adverse pregnancy outcomes such as fetal growth restriction and preterm birth.

OBJECTIVETo investigate the autopsy characteristics, pathologic type, malfomation and genetic characteristics of complete atrioventricular septal defect (CAVSD).

METHODSThirty five cases of CAVSD were collected from Maternal and Child Hospital of Haidian District during Jan.2003 to Jan.2015. Autoptic material, clinical history and chromosome examination were reviewed.

RESULTSAmong 35 cases of CAVSD between 18-38 gestational weeks, there were 26 cases with CAVSD A (74.3%, 26/35), 1 case with CAVSD B (2.8%, 1/35) and 8 cases with CAVSD C (22.8%, 8/35). Only CAVSD malformation was seen in 4 cases (11.4%, 4/35). Multiple malformations were seen in 31 cases (88.6%, 31/35). Combined malformations most frequently occurred in cardiovascular, respiratory and locomotor system. Among 15 cases with chromosome examination, chromosome aberrations was found in 13 cases (13/15) and trisomy-21 was found in 11 cases (11/15).

CONCLUSIONSCAVSD is a rare disease and CAVSD A is the most common type. CAVSD is usually combined with other malformations and chromosome aberrations.

Abnormalities, Multiple ; genetics ; pathology ; Autopsy ; Chromosome Aberrations ; Gestational Age ; Heart Septal Defects ; Humans ; Mitral Valve Insufficiency ; genetics ; pathology

OBJECTIVETo study the etiology, pathogenesis, clinicopathologic characteristics, prognosis and treatment of congenital pulmonary airway malformation (CPAM).

METHODSEighteen cases of CPAM were enrolled into the study. The clinical history, autopsy findings and immunohistochemical results were evaluated, with review of literature. The pathogenetic mechanism, pathologic features and differential diagnosis of CPAM were studied.

RESULTSHistologic examination showed that 2 cases were classified as Stocker type I, 12 cases as type II, and 4 cases as type III. The lesion was unilateral and involved single lobe in 13 cases. The remaining 5 cases had bilateral diseases. Of the 18 cases studied, 12 cases showed single organ involvement and 6 cases had malformations affecting multiple organs. The associated malformations included cardiac anomalies (4 cases), polycystic kidney with gastrointestinal atresia (1 case) and nuchal cystic hygroma with hydrothorax (1 case).

CONCLUSIONSCPAM is a rare pulmonary disorder. The etiology of this non-neoplastic condition is unknown. Imaging analysis is a valuable tool to suggest CPAM, while definite diagnosis requires pathologic examination. The overall prognosis is determined by the presence of associated malformations, fetal hydrops and pulmonary hypoplasia.

Abnormalities, Multiple ; pathology ; Autopsy ; Fetus ; abnormalities ; Humans ; Hydrops Fetalis ; Lung ; abnormalities

Objective To investigate the diagnosis value of p16 combined with Ki67 protein in cervical lesions.Methods Totally 1 542 women with previous liquid-based cytology smear result of abnormality underwent a colposcopy-directed biopsy excision procedure.Biopsy specimens were detected by p16 and Ki67 immunostaining alongside hematoxylin and eosin (H&E) staining.A four-semiquantitative class was used to describe the immunohistochemical results.Results Biopsy results revealed 1 542 women included 473 women with negative for dysplasia (NEG),629 women with cervical intraepithelial neoplasia (CIN) Ⅰ,206 women with CIN Ⅱ,206 women with CINⅢ and 28 women with cervical squamous cell carcinoma (SCC).The averageage of this study population was 34.47 years.CINs mainly occurred in women aged 20-29 years and 30-39 years.The positive rates of p16 in NEG,CIN Ⅰ,CIN Ⅱ,CINⅢ and SCC were 15.22％,60.25％,98.06％,99.51％,100.00％ respectively,and the positive rates of Ki67 were 12.05％,63.12％,96.12％,98.06％,100.00％ respectively.p16 expression and Ki-67 expression significantly increased with disease progression (p16:r =0.758,P =0.000 ; Ki67:r =0.773,P =0.000).Expression level of p16 was positively related with Ki-67 (r =0.774,P =0.000).The positive expression rates of p16 and Ki-67 of NEG were significantly lower than those of CIN and SCC (p16:x2 =1 127.46,P =0.000;Ki67:x2 =1 316.85,P =0.000).The positive expression rates of p16 and Ki-67 were markedly higher in CIN Ⅰ than those in CINⅡ,CINⅢⅢ and SCC (p16:x2 =500.19,P =0.000;Ki67:x2 =603.23,P=0.000).Conclusion Women aged 20-39 years are key subjects for cervical cancer screening.p16 and Ki67 immunohistochemistry is important in the ancillary diagnosis of cervical lesions.

Objective To prospectively compare the clinical effect of 131I therapy for Graves disease (GD) using the 131I-iodide dose determined by radioactive iodine uptake formula and by individualized experience method respectively.Methods (1) A total of 527 GD patients referred for 131I therapy were enrolled and divided into two groups using interval sampling method.Group 1 consisted of 241 patients with their 131I activity calculated by iodine uptake formula.Group 2 consisted of 286 patients with their 131I activity calculated by individualized method based on clinical experience.(2) The patients who were not cured for the first time were retreated after 3 months in the same way until remission.(3) All patients were followed for more than 1 year after GD was cured.The clinical outcome was compared between the 2 groups.x2 test and two-sample t test were used for data analysis.Results There were no significant differences in age,gender,disease course,ATD pretreatment,the time of ATD discontinuation,level of thyroid hormone and autoantibody before 131I therapy,131I uptake rate,size of thyroid and duration of follow-up between the two groups (t=0.156-1.430,x2 =0.159,all P＞0.05).Group 1 had less 131I dose than group 2 ((247.9± 107.3) MBq vs (329.3±177.6) MBq,t=6.102,P＜0.05),fewer patients whose disease was controlled at early stage (x2 =25.279,P＜0.05) and lower remission rate for the first time of treatment (x2 =13.074,P＜ 0.05),but higher repeated treatment rate (t =2.735,P＜0.05) and ratio of hypothyroidism to normalized patients at the first treatment (x2=10.190,P＜0.05).The number of patients with permanent hypothyroidism between the two groups had no statistically significant difference (x2=1.138,P＞0.05).Conclusions The first treatment dose of 131I by individualized experience method is slightly higher than that by radioactive iodine uptake formula.Individualized treatment method for GD based on experience might help to control the GD earlier and improve the one-off remission rate without increasing the rate of hypothyroidism.

OBJECTIVETo investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.

METHODSTwenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.

RESULTSThe average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.

CONCLUSIONSPlacental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.

Adult ; Diagnosis, Differential ; Endothelial Cells ; pathology ; Female ; Fetal Death ; Hemangioma ; pathology ; Humans ; Infant, Newborn ; Placenta ; pathology ; Placenta Diseases ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; Stillbirth

Abnormalities, Multiple ; Craniofacial Abnormalities ; Humans

Female ; Humans ; Luteoma ; pathology ; Ovarian Neoplasms ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology

Objective To study the etiology, pathogenesis, clinicopathologic characteristics, prognosis and treatment of congenital pulmonary airway malformation (CPAM).Methods Eighteen cases of CPAM were enrolled into the study.The clinical history, autopsy findings and immunohistochemical results were evaluated, with review of literature.The pathogenetic mechanism, pathologic features and differential diagnosis of CPAM were studied.Results Histologic examination showed that 2 cases were classified as Stocker typeⅠ, 12 cases as type Ⅱ, and 4 cases as type Ⅲ.The lesion was unilateral and involved single lobe in 13 cases.The remaining 5 cases had bilateral diseases.Of the 18 cases studied, 12 cases showed single organ involvement and 6 cases had malformations affecting multiple organs.The associated malformations included cardiac anomalies ( 4 cases ) , polycystic kidney with gastrointestinal atresia (1 case) and nuchal cystic hygroma with hydrothorax (1 case).Conclusions CPAM is a rare pulmonary disorder.The etiology of this non-neoplastic condition is unknown.Imaging analysis is a valuable tool to suggest CPAM, while definite diagnosis requires pathologic examination.The overall prognosis is determined by the presence of associated malformations, fetal hydrops and pulmonary hypoplasia.

Objective To investigate the clinicopathological characteristics , diagnostic criteria and differential diagnosis of placental chorioangioma.Methods Twenty-five cases of placental chorioangioma were analyzed for their clinical data , histomorphology and immumohistochemical staining .Relevant literature was reviewed.Results The average age of the 25 patients was 29 years.Fourteen patients had full-term pregnancy , 10 had preterm labor , and 1 had intrauterine fetal death .Nineteen patients had pregnancy complications.The tumors presented as red or dusty pink nodules with clear borders.The tumor size ranged from 1 to 16 cm.Microscopically , the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells.These cells were positive for CD 34 and Ki-67 index <10%.Conclusions Placental chorioangioma is a rare benign tumor of the placenta , and is associated with various pregnancy complications .Misdiagnosis of cell-rich type tumor should be avoided .