背景:Lewis和Huff简要描述了尸检时一些胎儿阑尾(VA)中存在“微囊性隐膜炎”。我们进一步表征了这些隐窝变化(CC),它们发生的时机,并测试了它们与感染/炎症的关系。
方法:评估了345VA的苏木精和伊红染色载玻片是否存在CC及其不同形态。对尸检报告进行了审查,以了解羊水或胎儿全身感染和胎盘炎症的证据。
结果:有或没有管腔不规则的隐窝扩张,隐窝扩张与半减薄的上皮,腔内凋亡碎片和炎症细胞,尤其是嗜酸性粒细胞,并观察到有钙化或多核巨细胞的旋涡状细胞灶,无论是单独还是组合,在至少58.5%(202/345)的VA中。CC在17周开始出现,在20到25周达到峰值(在此期间高达82%的VA表现出CC),随后在妊娠28周后稳步下降。独立性的χ2检验显示,CC的存在和不存在与胎儿或胎盘感染状态之间没有显着关联(P=0.435;>0.05)。
结论:发育中的胎儿阑尾(VA)的未被识别的CC表现出明显的发生时间模式,似乎不受感染的存在或不存在的影响,到目前为止,这有利于它们成为正常肠道发育过程的一部分。
BACKGROUND: Lewis and Huff briefly described the presence of \"microcystic cryptitis\" in some of fetal vermiform appendices (VA) at autopsy. We further characterized these crypt changes (CC), their timing of occurrence, and tested their association with infection/inflammatory conditions.
METHODS: Hematoxylin and eosin-stained slides of 345 VA were evaluated for the presence or absence of CC and their different morphologies. Autopsy reports were reviewed for evidence of amniotic fluid or fetal systemic infection and placental inflammatory conditions.
RESULTS: Crypt dilatation with or without irregularity of the lumen, crypt dilatation with semiattenuated epithelium, intraluminal apoptotic debris and inflammatory cells, especially eosinophils, and foci of swirled spindled cells with calcifications or multinucleated giant cells were observed, either alone or in combination, in at least 58.5% (202/345) of the VA. CC began to appear at 17 weeks, peaked at 20 to 25 weeks (with up to 82% of VA exhibiting CC during this time), and followed by a steady decline beyond 28 weeks gestation. χ2 test of independence showed no significant association (P = .435; >0.05) between the presence and absence of CC and infection status of the fetus or placenta.
CONCLUSIONS: The underrecognized CC of the developing fetal vermiform appendix (VA) showed distinct temporal pattern of occurrence and did not seem to be affected by the presence or absence of infection, which so far favored their being a part of the normal gut developmental process.