Uncultured blood smears hybridized with alpha satellite probes to diagnose 45,X in spontaneously aborted fetuses

Constellation of congenital abnormalities in an infant: a new syndrome or tissue-specific mosaicism for trisomy 18?

A newborn infant born to consanguineous (first cousin) parents was noted to have complex congenital heart defect and minor anomalies suggestive of trisomy 18. Blood lymphocyte and skin fibroblast karyotypes were normal. He died in the neonatal period of postoperative complications. On interphase fluorescence in-situ hybridization (FISH) using autopsy specimens, a significant number of cells in the liver (17%) were trisomic for chromosome 18, compared to normal control liver tissue. However, interphase FISH analyses of blood lymphocytes, skin fibroblasts, and kidney tissue were normal. It is our opinion that this apparent mosaicism for trisomy 18 in the patient's liver may be spurious, though it brings into focus the issue of possible tissue/organ-specific mosaicism. The anomalies in this infant do not resemble a previously described malformation syndrome. Parental consanguinity raises the possibility that this represents a new autosomal recessive malformation syndrome.

Genetic diagnosis from formalin-fixed fetal tissue using FISH: a new tool for genetic counseling in subsequent pregnancies

We evaluated the feasibility of retrospective genetic testing for numerical chromosomal aberrations by applying the FISH technique to formalin-fixed fetal tissue. Fetal tissue from 10 old cases with known aneuploidy and from 13 cases with known fetal malformations, were tested with specific DNA probes for pericentromeric repeat regions of chromosomes 13/21, 18, X and Y. FISH diagnosis concurred with karyotype in all nine cases with sufficient cells. Numerical aberration was diagnosed in six out of 13 cases with fetal malformations.

Evaluation of interphase fluorescence in situ hybridization on direct hematological bone marrow smears

Traditional cytogenetic analysis from bone marrow aspirates is time consuming and frequently suboptimal due to poor viability of cells in culture. Fluorescence in situ hybridization (FISH) with appropriate DNA probes is a potential alternative to routine cytogenetics. Our study examined the reliability of uptake of specific alpha satellite centromere probes from chromosome 18 (D18Z1) and X (DXZ1) and the Yq heterochromatin (pHY3.4) directly from routine hematological bone marrow smears. Altogether 34 separate hybridizations, performed on slides from 20 patients, were scored for fluorescence signals. Cells in interphase were examined with each probe using unstained slides. In addition Giemsa stained slides were destained and then used for interphase FISH. Between 412 and 631 cells were scored for the expected number of signals; 2 for the 18 centromere, 2 for the X centromere in females, one signal for the Yqh in males. The results showed the expected number of signals in 87-97% of cells with the 18 and X probes and 95-97% of cells with the Y probe. Interphase FISH is a reliable, reproducible technique for use on direct bone marrow smears.

Confined placental mosaicism and stillbirth

The cause of stillbirth can usually be determined in only 20% of cases. An increased frequency of adverse pregnancy outcome, including pregnancy loss, intrauterine growth restriction, and premature labor, has been observed in association with confined placental mosaicism (CPM), which is characterized by a discrepancy between the karyotype of the fetus and placenta. Specific chromosomal trisomies have been observed in CPM more frequently than others, with trisomy of chromosomes 7, 16, and 18 being the most prevalent. In pregnancies with CPM it has been shown that the zygote is often trisomic, and postzygotic loss of the additional chromosome occurred in the embryonic progenitor cells leading to a dichotomy between the placenta and the embryo/fetus. In one third of such cases fetal uniparental disomy (UPD), which is the presence of both homologues of a chromosome derived from one parent, can be expected. The specific role of the trisomic placenta and the presence of fetal UPD in cases of altered intrauterine fetal development has not been fully established for various chromosomes. Therefore, to enhance our understanding of the pathogenesis of stillbirth it is imperative that cytogenetic analysis of both fetal and placental tissues be performed in all cases of unexplained stillbirth.