Leng Xue-Fei, Lei Ke, Li Yi, Tian Fei, Yao Qin, Zheng Qing-Mei, Chen Zhi-Hong
Department of Pediatric Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao 266001, Shandong Province, China.
Department of Laboratory Medicine, Affiliated Hospital of Medical College Qingdao University, Qingdao 266001, Shandong Province, China.
World J Clin Cases. 2020 Nov 26;8(22):5737-5743. doi: 10.12998/wjcc.v8.i22.5737.
Turner syndrome (TS) has a variety of different karyotypes, with a wide range of phenotypic features, but the specific karyotype may not always predict the phenotype. TS with Y chromosome mosaicism may have mixed gonadal dysgenesis, and the mosaicism is related to the potential for gonadoblastoma.
In this case report, we report two cases of TS with different karyotypes and gonadal dysgenesis. Patient 1 had obvious virilization, and was positive for the gene, but her karyotype in peripheral blood lymphocytes was 45X. Patient 2 had a mosaic karyotype, 45X/46X, dic (Y:Y) (p11.3:p11.2), and the proportion of Y-bearing cells was 50% in peripheral blood lymphocytes, but the patient had normal female external genitalia and streaky gonads, with no genital virilism. Different tissues in the same TS individual may exhibit different ratios of mosaicism. The gonadal determination and differentiation of mosaic TS are primarily dependent on the predominant cell line in the gonads.
In TS patients with virilization, it is necessary to test at least two to three tissues to search for cryptic Y material.
特纳综合征(TS)有多种不同的核型,伴有广泛的表型特征,但特定的核型并不总是能预测表型。伴有Y染色体嵌合体的TS可能存在混合性性腺发育不全,且这种嵌合体与性腺母细胞瘤的发生可能性有关。
在本病例报告中,我们报告了两例具有不同核型和性腺发育不全的TS病例。患者1有明显的男性化表现, 基因检测呈阳性,但其外周血淋巴细胞的核型为45,X。患者2的核型为嵌合体,45,X/46,X, dic(Y:Y)(p11.3:p11.2),外周血淋巴细胞中含Y细胞的比例为50%,但该患者女性外生殖器正常,性腺呈条索状,无生殖器男性化表现。同一TS个体的不同组织可能表现出不同比例的嵌合体。嵌合型TS的性腺决定和分化主要取决于性腺中占主导的细胞系。
对于有男性化表现的TS患者,有必要检测至少两到三种组织以寻找隐匿的Y物质。