Arizawa Masayoshi, Nakayama Masahiro
Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
Congenit Anom (Kyoto). 2002 Dec;42(4):309-17. doi: 10.1111/j.1741-4520.2002.tb00897.x.
So far, 46 cases of placental mesenchymal dysplasia have been reported worldwide. We encountered 15 cases of placental mesenchymal dysplasia (PMD) including 7 cases delivered in our hospital. The incidence of PMD in our hospital was therefore, 7/30,758 (0.02%). The PMD had a peculiar appearance. In the gross findings, large placenta with intestine-like dilatation of the vessels on the fetal side was reported. Microscopically, cistern-like dilatation of the stem villi, fetal artery thrombosis, and villous hemorrhage were reported. However, we believe most of these findings are secondary rather than the primary of mesenchymal dysplasia. Therefore, we investigated 15 other cases of mesenchymal dysplasia, and found including vascular abnormality of the stem, intermediate and terminal villi in all case of PMD. The abnormality was observed in the vessels of the periphery of the stem villi and their vessel walls were thin and appeared weak. The intermediate villous vessels were unusual, tangled. The terminal villous abnormalities showed chorangiosis and stromal hyperplasia. These findings are mesenchymal dysplasia origin. Moreover, PMD showed female-predominant. 14/15 was female among our cases, We discuss the relationship between mesenchymal dysplasia and the X chromosome in this paper.
迄今为止，全球已报道46例胎盘间质性发育异常。我们遇到15例胎盘间质性发育异常（PMD），其中7例在我院分娩。我院PMD的发病率为7/30758（0.02%）。PMD有独特的外观。大体检查发现，有报道称胎盘大，胎儿侧血管呈肠样扩张。显微镜下，有报道称干绒毛呈池样扩张、胎儿动脉血栓形成和绒毛出血。然而，我们认为这些发现大多是继发性的，而非间质性发育异常的原发性表现。因此，我们研究了另外15例间质性发育异常病例，发现在所有PMD病例中均存在干、中间和终末绒毛的血管异常。在干绒毛周边的血管中观察到异常，其血管壁薄且显得脆弱。中间绒毛血管异常，相互缠绕。终末绒毛异常表现为绒毛血管瘤和间质增生。这些发现源于间质性发育异常。此外，PMD以女性为主。我们的病例中14/15为女性，本文将讨论间质性发育异常与X染色体之间的关系。
