Abba Deka Ioanna, Theotokis Paschalis, Manthou Maria Eleni, Mathioudi Angeliki, Athanasiou Evangelia, Meditskou Soultana
Department of Surgical Pathology, Medical School, Aristotle University of Thessaloniki, Greece.
Department of Histology and Embryology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
Congenit Anom (Kyoto). 2025 Jan-Dec;65(1):e70004. doi: 10.1111/cga.70004.
The current case report presents the postmortem examination findings of a 17-week-old female fetus displaying thanatophoric dysplasia type 1 (TD-1) due to a known fibroblast growth factor receptor 3 (FGFR3) gene mutation. Gross and X-ray examination revealed significant abnormalities, including skeletal malformations with prominent TD-1 femur curvature. Microscopical evaluation indicated inadequate histological growth for the gestational age, with specific organ immaturity noted in multiple hematoxylin and eosin sections from internal organs, bone from epiphyses and diaphyses levels. Immunohistochemical analysis was conducted using specific markers, such as S100, CD34, CD117, glycophorin-C, and myeloperoxidase, to identify various hematopoietic and mesenchymal cell types. Furthermore, this report underscores the often-overlooked aspect of fetal hematopoiesis in cases diagnosed with TD-1, shedding light on the development of hematopoietic cells and their markers in various tissues, with a particular emphasis on the investigation of bone marrow foci in areas with incipient or no apparent ossification. Immunohistochemical identification of hematopoiesis also served as an indirect way to identify areas of incipient or abnormal ossification.
本病例报告展示了一名17周龄女性胎儿的尸检结果,该胎儿因已知的成纤维细胞生长因子受体3(FGFR3)基因突变而表现出1型致死性骨发育不全(TD-1)。大体和X线检查发现了显著异常,包括骨骼畸形以及明显的TD-1型股骨弯曲。显微镜评估显示,其组织学生长与胎龄不符,在取自内脏器官、骨骺和骨干水平骨骼的多个苏木精和伊红切片中均发现特定器官不成熟。使用特定标志物(如S100、CD34、CD117、血型糖蛋白-C和髓过氧化物酶)进行免疫组织化学分析,以识别各种造血和间充质细胞类型。此外,本报告强调了在诊断为TD-1的病例中常常被忽视的胎儿造血方面,揭示了造血细胞及其标志物在各种组织中的发育情况,尤其着重于对初期或无明显骨化区域骨髓灶的研究。造血的免疫组织化学鉴定也作为一种间接方法来识别初期或异常骨化区域。