Pediatric pathology
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The article deals with paediatric pathology, which is quite different than adult pathology. Many diseases that afflict children are uncommon or unheard of in adults.
Gastrointestinal pathology
Necrotizing enterocolitis
General
- Disease of the newborn.
- Diagnosed by imaging.
Microscopic
Features:
- Large spaces.
Images:
Persistent pulmonary hypertension of the newborn
- Abbreviated PPHN.
- Related to patent ductus arteriosus and persistent fetal circulation.[2]
Associations:[3]
- Meconium aspiration.
- Anemia.
- Infection.
- Pneumonia (severe).
- Hypoglycemia.
- Birth asphyxia.
Hypoxic-ischemic encephalopathy
Main article: Neuropathology
- Abbreviated HIE.
General
- Autopsy adds some information.
- Two-tone liver - suggests prior injury.[4]
- HIE in perinatal period may be unique to the specific time of the injury, i.e. the type of hypoxic insults vary by developmental stage.[5]
- Some hypoxic injuries that are prenatal do not occur after birth.
- Pontosubicular necrosis is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults.
- Hypoxic-ischemic insults are predominantly in the white matter. (???)
- Some hypoxic injuries that are prenatal do not occur after birth.
- HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.[6]
Possible findings in HIE
Hemorrhagic lesions:[7]
- Germinal matrix & intraventricular hemorrhage.
- Choroid plexus hemorrhage.
- Cerebellar hemorrhage.
- Subpial hemorrhage.
White matter lesions:[7]
- Periventricular leukomalacia.
- Subcortical leukomalacia.
- Telencephalic (cerebral) leukomalacia.
Grey matter lesions:[7]
- Pontosubicular necrosis.
- Infarcts of the cerebral cortex, basal ganglia, thalamus, brain stem.
Germinal matrix hemorrhage
- Arises from the germinal matrix, the tissue from which neurons and glial arise from.[8]
- Location: periventricular; may cause an intraventricular hemorrhage.
- Image: Germinal matrix (nlm.nih.gov).[8]
- Location: periventricular; may cause an intraventricular hemorrhage.
- The germinal matrix is thought to be intrinsically fragile and is especially so in premature infants.
References
- ↑ URL: http://cueflash.com/decks/Pathology_Pediatrics. Accessed on: 11 January 2011.
- ↑ URL: http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx. Accessed on: 4 January 2011.
- ↑ URL: http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx. Accessed on: 4 January 2011.
- ↑ Elder DE, Zuccollo JM, Stanley TV (July 2005). "Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?". BJOG 112 (7): 935–40. doi:10.1111/j.1471-0528.2005.00608.x. PMID 15957995.
- ↑ Grafe MR, Kinney HC (February 2002). "Neuropathology associated with stillbirth". Semin. Perinatol. 26 (1): 83–8. PMID 11876572.
- ↑ URL: http://emedicine.medscape.com/article/973501-overview. Accessed on: 7 January 2011.
- ↑ 7.0 7.1 7.2 Riezzo I, Neri M, De Stefano F, et al. (2010). "The timing of perinatal hypoxia/ischemia events in term neonates: a retrospective autopsy study. HSPs, ORP-150 and COX2 are reliable markers to classify acute, perinatal events". Diagn Pathol 5: 49. doi:10.1186/1746-1596-5-49. PMC 2914029. PMID 20626887. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914029/.
- ↑ 8.0 8.1 Ballabh P (January 2010). "Intraventricular hemorrhage in premature infants: mechanism of disease". Pediatr. Res. 67 (1): 1–8. doi:10.1203/PDR.0b013e3181c1b176. PMC 2799187. PMID 19816235. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799187/.