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Noguchi Y, Shidei T, Morioka C, Kashimada K, Morio T. A suspected case of heterotopic glia in an MM-twin discordant for anencephaly. Pediatr Int 2022; 64:e15027. [PMID: 35396791 DOI: 10.1111/ped.15027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/23/2021] [Accepted: 10/13/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Yusuke Noguchi
- Department of Pediatrics, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tsunanori Shidei
- Department of Pediatrics, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Chikako Morioka
- Department of Pediatrics, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Kenichi Kashimada
- Department of Pediatrics, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics, Tokyo Medical and Dental University Hospital, Tokyo, Japan
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Dixit P, Shukla A, Raj A, Singh S. Anaesthetic management for excision of rare right pulmonary glial heterotopia in a post COVID-19 survival paediatric patient. Indian J Anaesth 2021; 65:S177-S178. [PMID: 34908571 PMCID: PMC8613476 DOI: 10.4103/ija.ija_152_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/28/2021] [Accepted: 08/21/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Priya Dixit
- Department of Anaesthesiology and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aparna Shukla
- Department of Anaesthesiology and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aanchal Raj
- Department of Anaesthesiology and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shailendra Singh
- Department of Anaesthesiology and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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Glavis-Bloom J, Nahl D, Rubin EM, Nael A, Dao T. Congenital neuroglial choristoma of the foot. Radiol Case Rep 2019; 14:718-722. [PMID: 30988863 PMCID: PMC6447744 DOI: 10.1016/j.radcr.2019.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/21/2019] [Accepted: 03/24/2019] [Indexed: 11/28/2022] Open
Abstract
Neuroglial choristomas are rare malformations of heterotopic neural tissue that have been previously reported predominantly in the head and neck. Competing theories of embryogenesis propose their origin as encephaloceles that have undergone resorption of their cranial connection or displaced neuroectodermal cells which have undergone ectopic proliferation. Most cases occur in midline or para-midline structures. There have been no prior published cases of a neuroglial choristoma in the extremities. We present a case of a 13-month-old otherwise healthy child who presented to our institution with a slowly growing foot mass who was found to have a neuroglial choristoma. This case suggests an early embryological migration defect as the etiology and offers a unique differential consideration for a benign extremity mass.
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Affiliation(s)
- Justin Glavis-Bloom
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Daniel Nahl
- Department of Diagnostic Imaging, Children's Hospital of Orange County, Orange, CA, USA
| | - Elyssa M Rubin
- Department of Oncology, Children's Hospital of Orange County, Orange, CA, USA
| | - Ali Nael
- Department of Pathology, Children's Hospital of Orange County, Orange, CA, USA
| | - Tuan Dao
- Department of Diagnostic Imaging, Children's Hospital of Orange County, Orange, CA, USA
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Tournier L, Berrebi D, Peuchmaur M, Bonnard A, Belarbi N, Sibony O, Morcrette G. [Pulmonary glial heterotopia: Unique lesion in an infant with anencephalic twin]. Ann Pathol 2018; 39:24-28. [PMID: 30553644 DOI: 10.1016/j.annpat.2018.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/03/2018] [Accepted: 08/13/2018] [Indexed: 11/30/2022]
Abstract
Pulmonary glial heterotopia is an extremely rare entity whose pathophysiology remains unclear. We report for the first time one case of pulmonary glial heterotopia occured in a one-month baby free from any malformation. She has the particularity of being born from monozygotic monochorionic twin pregnancy where her anencephalic exencephalic sister suffered a medical termination of pregnancy. She presented neonatal respiratory distress, which recurred one month later. Chest X-ray revealed bilateral cystic pulmonary lesions mainly located in the right lung. Given the suspicion of congenital cystic adenomatoid malformation (CCAM), she underwent an upper and a lower right lung lobectomy at four months old. The pathological study found a multi-cystic lesion consisted of well-differentiated and poorly cellular glial tissue sometimes lined by bronchic epithelium. There was no pathological evidence for a CCAM. The evolution was favorable after surgery with an infant who was well five months later. This is one of the very few cases where the disease did not lead to rapid death in utero or during the perinatal period. This suggests that effective management by surgery could be a decisive factor in the survival of these patients.
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Affiliation(s)
- Louis Tournier
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Dominique Berrebi
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France.
| | - Michel Peuchmaur
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Arnaud Bonnard
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de chirurgie générale, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Nadia Belarbi
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de radiologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Olivier Sibony
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de gynécologie obstétrique, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Guillaume Morcrette
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
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Abstract
BACKGROUND Pulmonary glial heterotopia is rare and its pathogenesis is still obscure as for Fanconi anemia (FA). OBSERVATION This study describes a very rare case of an incidental finding of pulmonary glial heterotopia in a girl diagnosed with FA, epilepsy, and mental retardation. Before this report, the association of pulmonary glial heterotopia and FA had not been described. CONCLUSIONS The unique finding in this patient could be a link between FA and abnormal cell migration, but it certainly teaches us that there is still much to be learnt of the molecular mechanisms underlying the clinical manifestations in FA.
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Quemelo PRV, Peres LC. Proliferation and cell death in an experimental model of brain tissue heterotopia in the lung. Acta Cir Bras 2010; 25:328-31. [PMID: 20676489 DOI: 10.1590/s0102-86502010000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 04/14/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate the proliferation and neuronal death in brain tissue heterotopia in the lung in an experimental model during both fetal and neonatal periods. METHODS Twenty four pregnant female Swiss mice were used to induce brain tissue heterotopia on the 15th gestational day. Briefly, the brain of one fetus of each dam was extracted, disaggregated and injected into the right hemithorax of siblings. Six of these fetuses with pulmonary brain tissue implantation (PBI) were collected on the 18th gestational day (group E18) and six other on the 8th postnatal day (group P8). Immunohistochemical staining for PCNA and Bcl2 were used to assess proliferation and cell death. RESULTS PCNA Labelling Index (LI) in heterotopic brain tissue was greater in fetal than postnatal period (E18 > P8) (p<0.05) and the immunostaining with Bcl2 antibody did not show difference. CONCLUSION Cell proliferation is maintained in brain tissue heterotopia, although apoptosis is also observed.
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Dettmer P, Beck M, Eufinger H, Rossler L, Tannapfel A, Coerdt W, Tröbs RB. Bilateral cystic pulmonary glial heterotopia and palatinal teratoma causing respiratory distress in an infant. J Pediatr Surg 2009; 44:2206-10. [PMID: 19944234 DOI: 10.1016/j.jpedsurg.2009.07.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Accepted: 07/03/2009] [Indexed: 11/30/2022]
Abstract
We report on a male infant with extensive, bilateral cystic and solid lung lesions who presented postnatally with respiratory distress caused by bilateral cystic lung lesions. Parenchyma-sparing resections were performed. Histology revealed the presence of neuroglial cell-lined cysts and glial nodules. In addition, a neural element containing palatinal teratoma was detected and excised. Based on previously published cases, the pathogenesis and clinical features of pulmonary neuroglial heterotopia are discussed.
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Affiliation(s)
- Petra Dettmer
- Department of Pediatric Surgery, Catholic Foundation Marienhospital Herne, Ruhr-University of Bochum, D-44627 Herne, Germany
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Quemelo PRV, Peres LC. Neuronal maturation in an experimental model of brain tissue heterotopia in the lung. Exp Biol Med (Maywood) 2008; 233:535-9. [PMID: 18375827 DOI: 10.3181/0709-rm-245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Neural maturation involves diverse interaction and signaling mechanisms that are essential to the development of the nervous system. However, little is known about the development of neurons in heterotopic brain tissue in the lung, a rare abnormality observed in malformed babies and fetuses. The aim of this study was to identify the neurons and to investigate their maturation in experimental brain tissue heterotopia during fetal and neonatal periods. The fetuses from 24 pregnant female Swiss mice were used to induce brain tissue heterotopia on the 15th gestational day. Briefly, the brain of one fetus of each dam was extracted, disaggregated, and injected into the right hemithorax of siblings. Six of these fetuses with pulmonary brain tissue implantation were collected on the 18th gestational day (group E18), and six others were collected on the 8th postnatal day (group P8). The brain of each fetus from dams not submitted to any experimental procedure was collected on the 18th gestational day (group CE18) and on the 8th postnatal day (group CP8) to serve as a control for neuronal quantitation and maturation. Immunohistochemical staining of NeuN was used to assess neuron quantity and maturation. The NeuN labeling index was greater in the postnatal period than in the fetal period for the experimental and control groups (P8 > E18 and CP8 > CE18), although there were fewer neurons in experimental than in control groups (P8 < CP8 and E18 < CE18) (P < 0.005). These results indicate that fetal neuroblasts/neurons not only survive a dramatic event such as mechanical disaggregation, in the same way as it happens in human cases, but also they retain their development in heterotopia, irrespective of local tissue influences.
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Affiliation(s)
- Paulo Roberto Veiga Quemelo
- Department of Pathology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto - SP -Brazil, 14049-900
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Quemelo PRV, Sbragia L, Peres LC. Development of an experimental model of brain tissue heterotopia in the lung. Int J Exp Pathol 2007; 88:337-42. [PMID: 17877535 PMCID: PMC2517333 DOI: 10.1111/j.1365-2613.2007.00536.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The presence of heterotopic brain tissue in the lung is a rare abnormality. The cases reported thus far are usually associated with neural tube defects (NTD). As there are no reports of experimental models of NTD that present this abnormality, the objective of the present study was to develop a surgical method of brain tissue heterotopia in the lung. We used 24 pregnant Swiss mice divided into two groups of 12 animals each, denoted 17GD and 18GD according to the gestational day (GD) when caesarean section was performed to collect the fetuses. Surgery was performed on the 15th GD, one fetus was removed by hysterectomy and its brain tissue was cut into small fragments and implanted in the lung of its litter mates. Thirty-four live fetuses were obtained from the 17GD group. Of these, eight (23.5%) were used as control (C), eight (23.5%) were sham operated (S) and 18 (52.9%) were used for pulmonary brain tissue implantation (PBI). Thirty live fetuses were obtained from the females of the 18GD group. Of these, eight (26.6%) were C, eight (26.6%) S and 14 (46.6%) were used for PBI. Histological examination of the fetal trunks showed implantation of GFAP-positive brain tissue in 85% of the fetuses of the 17GD group and in 100% of those of the 18GD group, with no significant difference between groups for any of the parameters analysed. The experimental model proved to be efficient and of relatively simple execution, showing complete integration of the brain tissue with pulmonary and pleural tissue and thus representing a model that will permit the study of different aspects of cell implantation and interaction.
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Affiliation(s)
- Paulo Roberto Veiga Quemelo
- Department of Pathology, Ribeirão Preto School of Medicine, University of São PauloRibeirão Preto, SP, Brazil
| | - Lourenço Sbragia
- Division of Pediatric Surgery, Department of Surgery, University of CampinasCampinas, SP, Brazil
| | - Luiz Cesar Peres
- Department of Pathology, Ribeirão Preto School of Medicine, University of São PauloRibeirão Preto, SP, Brazil
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Abstract
One of the most critical events of birth is the conversion of the fluid-filled lung, unimportant to fetal intrauterine existence, into a hollow organ distended with air and capable of gaseous exchange sufficient to support life. Indeed, it has been argued that the major determinant of perinatal survival is respiratory function (Wigglesworth and Desai 1982). The failure to make this conversion adequately may lead, directly or indirectly, to infant death, and the pathologist often needs to assess the contribution made by respiratory inadequacy to the sequence of events leading to death. In the preterm infant, problems are mainly related to pulmonary immaturity and associated therapy. In the mature infant, birth asphyxia primarily results in cerebral damage but can engender significant respiratory complications when associated with aspiration of meconium. Even in stillbirths, where primary pulmonary pathology is rarely a cause of death, lung pathology may provide clues to antecedent events. Poor lung growth and maturation may point to the presence of pathology elsewhere. Consequently, adequate pathological investigation of the fetal or infant respiratory system is critical in any perinatal autopsy.
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Abstract
The study aimed to find out how frequent is brain tissue aspiration and if brain tissue heterotopia could be found in the lung of human neural tube defect cases. Histological sections of each lobe of both lungs of 22 fetuses and newborn with neural tube defect were immunostained for glial fibrillary acidic protein (GFAP). There were 15 (68.2%) females and 7 (31.8%) males. Age ranged from 18 to 40 weeks of gestation (mean = 31.8). Ten (45.5%) were stillborn, the same newborn, and 2 (9.1%) were abortuses. Diagnosis were: craniorachischisis (9 cases, 40.9%), anencephaly (8 cases, 36,4%), ruptured occipital encephalocele and rachischisis (2 cases, 9.1% each), and early amniotic band disruption sequence (1 case, 4.5%). Only one case (4.5%) exhibited GFAP positive cells inside bronchioles and alveoli admixed to epithelial amniotic squames. No heterotopic tissue was observed in the lung interstitium. We concluded that aspiration of brain tissue from the amniotic fluid in neural tube defect cases may happen but it is infrequent and heterotopia was not observed.
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Affiliation(s)
- Luiz Cesar Peres
- Departamento de Patologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
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