Kim Ji Hyun, Hwang Si Eun, Rodríguez-Vázquez José Francisco, Murakami Gen, Cho Baik Hwan
1 Department of Anatomy, Chonbuk National University Medical School, Jeonju, Republic of Korea.
Pediatr Dev Pathol. 2014 Nov-Dec;17(6):431-40. doi: 10.2350/14-05-1484-OA.1. Epub 2014 Aug 18.
We identified 2 human embryos, with crown-rump lengths (CRLs) of 22 mm and 23 mm and a gestational age of approximately 7 weeks (O'Rahilly's stage 21-22), with liver agenesis and omphalocele. Serial histological sections were prepared of the entire body of one specimen, whereas sections of the neck, including the upper part of the heart, were missed for the other specimen as a result of tissue damage during the abortion. In addition, isolated omphalocele was assessed in another embryo (CRL = 25 mm) for comparison with atypical omphalocele in the embryos with liver agenesis. The 2 embryos with liver agenesis were characterized by (1) the absence of the anterior part of the diaphragm; (2) abnormality in the venous pole of the heart; (3) a normal stomach in the left upper abdominal cavity; and (4) normal pancreas development with normal midgut rotation. The most likely cause of liver agenesis, when combined with isolated omphalocele, was a defect in the anterior extension or migration of the septum transversum rather than a mechanical separation of the hepatic diverticulum from the septum transversum.
我们鉴定出2例人类胚胎,其顶臀长度(CRL)分别为22毫米和23毫米,孕周约为7周(奥腊希利分期21 - 22期),伴有肝缺如和脐膨出。对其中1个标本的整个身体制作了连续组织切片,而另1个标本由于流产时的组织损伤,遗漏了包括心脏上部的颈部切片。此外,在另一个胚胎(CRL = 25毫米)中评估了孤立性脐膨出,以与肝缺如胚胎中的非典型脐膨出进行比较。这2例肝缺如胚胎的特征为:(1)膈前部缺失;(2)心脏静脉极异常;(3)左上腹腔内胃正常;(4)胰腺发育正常且中肠旋转正常。肝缺如合并孤立性脐膨出时,最可能的原因是横隔向前延伸或迁移存在缺陷,而非肝憩室与横隔的机械性分离。